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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1463650
Achieving Prediabetes Reversal in China: A Nationwide Longitudinal Study on the Role of Blood Glucose and Lipid Management in Middle-Aged and Elderly Adults
Provisionally accepted- 1 Department of Clinical Nutrition, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- 2 Geriatric Medicine Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
Background: Prediabetes, impacting a third of the adult Chinese population, is linked to a variety of detrimental health outcomes. However, scant research has delved into the factors that affect a regression from prediabetes to normal glucose regulation (NGR) in middle-aged and elderly Chinese adults.We conducted a longitudinal analysis of 2,655 adults, aged 45 years and above, drawing data from wave 1 and wave 3 of the China Health and Retirement Longitudinal Study (CHARLS). We employed stepwise logistic regression to identify factors associated with the regression to NGR. Restricted Cubic Spline (RCS) analysis was used to evaluate the dose-response relationships between baseline fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) levels and the likelihood of regression to NGR. Attribution fraction (AF) analysis was conducted to measure the impact of modifiable factors on the regression of prediabetes. We further examined how changes in these factors were associated with regression to NGR.During the 4-year follow-up, 570 of 2,655 prediabetes participants regressed to NGR. Stepwise logistic regression identified older age, female sex, abdominal obesity (OR 0.70, 95% CI 0.57-0.86), elevated LDL-C (OR 0.69, 95% CI 0.48-0.97), higher FPG (OR 0.68, 95% CI 0.52-0.90), and higher HbA1c (OR 0.23, 95% CI 0.18-0.30) as factors associated with regression to NGR. AF analysis showed that a lower initial HbA1c was the most influential factor for regression to NGR. Additionally, evaluated blood lipid profiles reduced the odds of regression to NGR.This study underscores the influence of age, gender, abdominal obesity, LDL-C levels, FPG, HbA1c, and blood lipid profiles on the likelihood of reverting from prediabetes to NGR. It suggests that adopting a healthy lifestyle and preemptively mitigating these risks may be more beneficial than addressing them after they have been identified in clinical settings.
Keywords: prediabetes, Normal glucose regulation, cohort, Metabolic disorder, Middle-aged and elderly adults
Received: 12 Jul 2024; Accepted: 30 Dec 2024.
Copyright: © 2024 Yang, Liu, Huang and Deng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yao Liu, Department of Clinical Nutrition, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
Zhenhe Huang, Geriatric Medicine Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
Guifang Deng, Department of Clinical Nutrition, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
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