Key result
Prediabetes was established as an independent predictor of clinically-prevalent cardiovascular disease (PR 1.20), while type 2 diabetes mellitus remained independently associated with increased all-cause mortality (HR 1.89) after adjustment for traditional risk factors.
Why the study?
The study aimed to assess the prevalence of type 2 diabetes mellitus and prediabetes in the general population and to investigate their associated cardiovascular burden and clinical outcome.
Does prediabetes or type 2 diabetes mellitus increase the risk of cardiovascular disease and all-cause mortality compared to euglycaemia in the general population?
Cohort (n=15,010)
Does prediabetes or type 2 diabetes mellitus increase the risk of cardiovascular disease and all-cause mortality compared to euglycaemia in the general population?
Answers are grounded in this paper and cite their sources.
Prediabetes is associated with a significantly increased burden of cardiovascular risk factors and subclinical organ damage, highlighting the need for early cardiometabolic prevention strategies.
Aims To assess the prevalence of type 2 diabetes mellitus (T2DM) and prediabetes in the general population and to investigate the associated cardiovascular burden and clinical outcome. Methods and Results The study sample comprised 15,010 individuals aged 35–74 years of the population-based Gutenberg Health Study. Subjects were classified into euglycaemia, prediabetes and T2DM according to clinical and metabolic (HbA1c) information. The prevalence of prediabetes was 9.5% ( n = 1415) and of T2DM 8.9% ( n = 1316). Prediabetes and T2DM showed a significantly increased prevalence ratio (PR) for age, obesity, active smoking, dyslipidemia, and arterial hypertension compared to euglycaemia (for all, P < 0.0001). In a robust Poisson regression analysis, prediabetes was established as an independent predictor of clinically-prevalent cardiovascular disease (PR prediabetes 1.20, 95% CI 1.07–1.35, P = 0.002) and represented as a risk factor for asymptomatic cardiovascular organ damage independent of traditional risk factors (PR 1.04, 95% CI 1.01–1.08, P = 0.025). Prediabetes was associated with a 1.5-fold increased 10-year risk for cardiovascular disease compared to euglycaemia. In Cox regression analysis, prediabetes (HR 2.10, 95% CI 1.76–2.51, P < 0.0001) and T2DM (HR 4.28, 95% CI 3.73–4.92, P < 0.0001) indicated for an increased risk of death. After adjustment for age, sex and traditional cardiovascular risk factors, only T2DM (HR 1.89, 95% CI 1.63–2.20, P < 0.0001) remained independently associated with increased all-cause mortality. Conclusion Besides T2DM, also prediabetes inherits a significant cardiovascular burden, which translates into poor clinical outcome and indicates the need for new concepts regarding the prevention of cardiometabolic disorders.
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Schmitt et al. (2021) conducted a cohort in Prediabetes and Type 2 Diabetes Mellitus (n=15,010). Type 2 Diabetes Mellitus and Prediabetes vs. Euglycaemia was evaluated on All-cause mortality (Type 2 Diabetes Mellitus vs Euglycaemia, adjusted for traditional risk factors) (HR 1.89, 95% CI 1.63-2.20, p=<0.0001). Prediabetes was established as an independent predictor of clinically-prevalent cardiovascular disease (PR 1.20), while type 2 diabetes mellitus remained independently associated with increased all-cause mortality (HR 1.89) after adjustment for traditional risk factors.
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