对韩国人2型糖尿病自然史的纵向洞察:20年社区前性队列研究
Wonsuk Choi1,2, Joon Ho Moon3, Hun Jee Choe4
1Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, South Korea.
Journal of internal medicine
|August 26, 2025
概括
一旦糖尿病前期发展,糖尿病 (DM) 的进展很快,尽管个体通常会长时间保持正常血糖水平. 这项研究追踪了20年的代谢表型,以了解DM的自然史.
科学领域:
- 内分泌学和新陈代谢
- 公共卫生
- 流行病学
背景情况:
- 糖尿病前期,以孤立的禁食葡萄糖受损 (iIFG) 或葡萄糖耐受性受损 (IGT) 为特征,是2型糖尿病 (DM) 之前的关键阶段.
- 了解不同前糖尿病表型的自然史和进展率对于有针对性的干预和公共卫生策略至关重要.
研究的目的:
- 根据糖尿病前期的不同代谢表型,研究糖尿病 (DM) 的自然发展史.
- 估计基于社区的潜在队列中正常血糖和糖尿病前期状态的持续时间以及DM转变的概率.
主要方法:
- 一项以社区为基础的前性研究对7676名年龄在40至69岁之间没有DM的人进行了长达20年的跟踪.
- 每两年评估血糖参数,使用75g口服葡萄糖耐受性测试.
- 使用马尔科夫模型计算每年过渡的概率和每个血糖状态的平均停留时间 (正常血糖,iIFG,IGT,DM).
主要成果:
- 在参与者中,205人患有iIFG,1753人患有IGT. 在17年半的时间里,2313名患者 (30.1%) 患上了DM.
- 对于iIFG而言,每年的转换率为7.7%,对于IGT而言是6.9%.
- 个体在iIFG状态中平均花费6. 3年,在IGT状态中花费11. 9年,在DM状态中花费更长的时间.
结论:
- 个体可以保持正常血糖水平很长时间.
- 一旦开始,从糖尿病前期 (iIFG和IGT) 到糖尿病的进展相对较快.
- 前糖尿病的代谢表型会影响血糖状态的持续时间,但不会影响到DM的快速进展.
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