Intermediate hyperglycaemia and 10-year mortality in resource-constrained settings: the PERU MIGRANT Study.

Area of Science:

• Endocrinology
• Public Health
• Epidemiology

Background:

• Intermediate hyperglycemia, a precursor to type 2 diabetes, poses a significant global health challenge.
• Understanding its association with mortality is crucial for public health interventions, especially in diverse populations.

Purpose of the Study:

• To investigate the association between intermediate hyperglycemia, defined by fasting plasma glucose and HbA1c criteria, and all-cause mortality.
• To analyze this association in a 10-year cohort from a Latin American country (Peru).

Main Methods:

• The PERU MIGRANT Study analyzed three population groups (rural, rural-to-urban migrant, urban) from 2007/2008 to 2018.
• Intermediate hyperglycemia was defined using American Diabetes Association (ADA) and International Expert Committee (IEC) criteria for fasting plasma glucose and HbA1c.
• Cox proportional hazard models were used to estimate hazard ratios for all-cause mortality.

Main Results:

• The study included 976 participants with a mean age of 47.8 years; 52.5% were women.
• The prevalence of intermediate hyperglycemia varied by definition, reaching 38.5% using the ADA HbA1c criteria.
• In adjusted models, only the ADA HbA1c definition of intermediate hyperglycemia (5.7-6.4%) was significantly associated with increased all-cause mortality (HR 1.91, 95% CI 1.03-3.53).

Conclusions:

• Intermediate hyperglycemia, specifically when defined by American Diabetes Association HbA1c criteria, is associated with elevated 10-year mortality in the Peruvian cohort.
• HbA1c levels appear to be a significant factor associated with mortality in this specific population, underscoring its clinical relevance.