Association of early-onset diabetes, prediabetes and early glycaemic recovery with the risk of all-cause and cardiovascular mortality
- Authors
- Kim, Sung Min; Lee, Gyeongsil; Choi, Seulggie; Kim, Kyuwoong; Jeong, Su-Min; Son, Joung Sik; Yun, Jae-Moon; Kim, Sin Gon; Hwang, Seung-sik; Park, Seong Yong; Kim, Yeon-Yong; Park, Sang Min
- Issue Date
- 11월-2020
- Publisher
- SPRINGER
- Keywords
- All-cause mortality; Cardiovascular disease; Diabetes; Glycaemic recovery; Prediabetes
- Citation
- DIABETOLOGIA, v.63, no.11, pp.2305 - 2314
- Indexed
- SCIE
SCOPUS
- Journal Title
- DIABETOLOGIA
- Volume
- 63
- Number
- 11
- Start Page
- 2305
- End Page
- 2314
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/52064
- DOI
- 10.1007/s00125-020-05252-y
- ISSN
- 0012-186X
- Abstract
- Aims/hypothesis The increasing incidence of diabetes among young adults is a disease burden; however, the effects of early-onset diabetes, prediabetes and glycaemic recovery on CVD or mortality remain unclear. We aimed to investigate the association of these factors with 10 year all-cause mortality, CVD mortality and CVD incidence in Korean young adults. Methods This large and longitudinal cohort study included data from the Korean National Health Insurance Service-National Health Information Database; 2,502,375 young adults aged 20-39 years without diabetes mellitus and CVD at baseline were included. Glycaemic status was measured twice, first in 2002-2003 and second in 2004-2005. Changes in fasting glucose levels were evaluated according to fasting glucose status: normal fasting glucose (NFG; <5.5 mmol/l), impaired fasting glucose (IFG; 5.5-6.9 mmol/l), and diabetic fasting glucose (DFG; >= 7.0 mmol/l). Primary outcomes were all-cause and CVD mortality risk. The secondary outcome was incidence of CVD, including acute myocardial infarction and stroke. All outcomes arose from the 10 year follow-up period 1 Jan 2006 to 31 December 2015. Results Individuals with NFG at baseline, who were subsequently newly diagnosed with diabetes and prediabetes (IFG), had increased all-cause mortality (HR [95% CI] 1.60 [1.44, 1.78] and 1.13 [1.09, 1.18], respectively) and CVD incidence (1.13 [1.05, 1.23] and 1.04 [1.01, 1.07], respectively). In those with DFG at baseline, early recovery to NFG and IFG was associated with decreased all-cause mortality (0.57 [0.46, 0.70] and 0.65 [0.53, 0.81], respectively) and CVD incidence (0.70 [0.60, 0.81] and 0.78 [0.66, 0.91], respectively). Among patients with IFG at baseline, early recovery to NFG was associated with decreased CVD mortality (0.74 [0.59, 0.93]). Conclusions/interpretation Early-onset diabetes or prediabetes increased CVD risks and all-cause mortality after the 10 year follow-up. Furthermore, recovery of hyperglycaemia could reduce the subsequent 10 year risk for CVD incidence and all-cause mortality.
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