Prediabetes Phenotypes and All-Cause or Cardiovascular Mortality: Evidence From a Population-Based Study

Area of Science:

• Endocrinology and Metabolism
• Cardiovascular Disease Epidemiology
• Public Health and Preventive Medicine

Background:

• Prediabetes is diagnosed using multiple criteria: fasting plasma glucose (FPG), glycated hemoglobin A1C (HbA1C), and 2-hour postload plasma glucose (2h PG).
• The prognostic value of having multiple prediabetes diagnostic criteria on mortality risk remains incompletely understood.

Purpose of the Study:

• To investigate the association between the number of prediabetes diagnostic criteria met and subsequent all-cause and cardiovascular disease (CVD) mortality.
• To assess if a greater number of prediabetes defects predicts a higher risk of mortality.

Main Methods:

• Analysis of data from 4511 adults with prediabetes from the 2005-2016 National Health and Nutrition Examination Survey.
• Utilized Kaplan-Meier curves, Cox proportional hazards regression, and stratified analyses to compare mortality rates based on one, two, or three prediabetes criteria.
• Adjusted for potential confounders in multivariable regression models.

Main Results:

• A significant proportion of individuals met multiple prediabetes criteria: 60.78% met one, 29.60% met two, and 9.62% met all three criteria.
• Individuals meeting two or three prediabetes criteria showed significantly increased multivariable-adjusted hazard ratios for all-cause mortality (1.341 and 1.369, respectively) and CVD mortality (1.836 and 2.037, respectively) compared to those meeting one criterion.
• The association between multiple prediabetes criteria and CVD mortality was particularly pronounced in men.

Conclusions:

• The number of diagnostic criteria met for prediabetes is directly associated with increased risk of all-cause and cardiovascular disease mortality.
• Identifying individuals with multiple prediabetes defects may aid in risk stratification for cardiovascular events and overall mortality.