Change in fasting plasma glucose and incident type 2 diabetes mellitus: results from a prospective cohort study

Mozaffary, Amirhossein; Asgari, Samaneh; Tohidi, Maryam; Kazempour-Ardebili, Sara; Azizi, Fereidoun; Hadaegh, Farzad

doi:10.1136/bmjopen-2015-010889

Cited by 19 publications

(14 citation statements)

References 41 publications

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“…Fasting plasma glucose (FPG), 2-h plasma glucose, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured according to the standard protocols 34 . Type 2 diabetes was diagnosed based on the fasting plasma glucose ≥ 126 mg/dL or 2-h plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test 35 . The first occurrence of type 2 diabetes in individuals during the follow-up period was considered as diabetic condition 36 .…”

Section: Discussionmentioning

confidence: 99%

High genetic burden of type 2 diabetes can promote the high prevalence of disease: a longitudinal cohort study in Iran

Bonab

Zahedi

Daneshpour

2020

Sci Rep

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Type 2 diabetes (T2D) is emerging as one of the serious public health issues in both developed and developing counties. Here, we surveyed the worldwide population differentiation in T2D-associated variants and assessed the genetic burden of the disease in an ongoing Tehran Cardio-Metabolic Genetic Study (TCGS) cohort represented the Iranian population. We found multiple SNPs that were significantly depleted or enriched in at least one of the five populations of 1,000 Genome Project (African, American, East Asian, European, and South Asian) as well as the Iranian population. Interestingly, TCF7L2, a well-known associated gene with T2D, harbors the highest number of enriched risk alleles almost in all populations except for East Asian, where this gene embraces the largest number of significantly depleted risk alleles. The polygenic risk score (PRS) of the enriched risk alleles was calculated for 1,867 diabetic and 2,855 non-diabetic participants in the TCGS cohort, interestingly demonstrating that the risk of developing T2D was almost two times higher in top PRS quintile compared with the lowest quintile after adjusting for other known risk factors. Type 2 diabetes (T2D) is one of the major life-threatening diseases globally, accounting for 4.2 million deaths worldwide in 2019 as assessed by International Diabetes Federation (IDF) consortium 1,2. According to the IDF report, among 20 countries belongs to the Middle East and North Africa (MENA) region, Iran is ranked third with the highest number of adults (5.4 million) who suffered from diabetes. The prevalence of diabetes in Iran's adult population was 11.4% in 2014, estimating 9.2 million Iranian individuals will have diabetes by the year 2030 3. Type 2 diabetes is a common multifactorial metabolic disease, resulting from both genetic and non-genetic (environmental) factors. The heritability of T2D ranges from 20 to 80%, suggesting the considerable role of genetic factors in the development of T2D; the heritable component of the disease is polygenic where many genes and their variants contribute to an enhanced risk of T2D development 4. The advent of high-throughput genotyping technologies has created a significant breakthrough in understanding the underlying genetic components of complex diseases, including T2D. A large number of common and low-frequency T2D susceptibility variants have been characterized by the genome-wide association studies (GWAS) and the whole-genome sequencing 5-9. Most of these variants are located near genes that were previously known to be involved in diabetes pathogenesis, such as TCF7L2, CDKAL1, CDKN1C, and IGF2BP2 10. Among them, TCF7L2 is responsible for the largest proportion of the T2D-associated variance in the various ethnic groups 11. TCF7L2 encodes a transcription factor played a central role in the Wnt signaling pathway to regulate glucose homeostasis 12. Since not all individuals are equally affected by type 2 diabetes through the unhealthy lifestyle and some are more sensitive than others, the corresponding genetic variants ...

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Section: Discussionmentioning

confidence: 99%

High genetic burden of type 2 diabetes can promote the high prevalence of disease: a longitudinal cohort study in Iran

Bonab

Zahedi

Daneshpour

2020

Sci Rep

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“…Since the TLGS is a longitudinal cohort with repeated measurements for exposures, it gave us the opportunity to investigate the effect of changes of risk factors on outcomes. For instance, we demonstrated that the three-year increase in systolic and diastolic blood pressure were associated with increased risk of CVD independently (29); or this rise in fasting plasma glucose could help identify high risk populations for incident type 2 diabetes, independent of important traditional risk factors (30). We also showed the effect of changes in anthropometric measures on the incidence of diabetes, CVD and total mortality (23, 31, 32).…”

Section: Resultsmentioning

confidence: 99%

Outcomes in the Tehran Lipid and Glucose Study (TLGS) as a Longitudinal Population-Based Cohort Study and a Pragmatic Community Trial

Khalili

Azizi

Asgari

et al. 2018

Int J Endocrinol Metab

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ContextThe Tehran lipid and glucose study (TLGS) is one of the oldest population-based longitudinal cohort studies, providing knowledge about the incidence and risk factors of some non-communicable diseases (NCDs) in West Asia which hitherto was relatively scarce. We reviewed the methods and results related to the outcome measurements of this study.Evidence AcquisitionWe reviewed all the TLGS papers which reported the incidence of NCDs.ResultsThe TLGS was initiated in 1999 - 2001 on a population in district no. 13 of Tehran with the same age distribution of the overall Tehran population and with a middle socioeconomic status. Totally, 15005 individuals, aged ≥ 3 years, participated in the first examination; reexaminations were conducted in a triennial manner and 3550 individuals were added in the second examination. All participants were also followed up annually and asked about any medical event leading to hospitalization or death. A part of participants was assigned to an educational program for lifestyle modification. High incidence of cardiovascular disease (CVD), premature CVD, diabetes and hypertension (around 19, 6, 10 and 31 in men and 11, 5, 11 and 29 in women per 1000 person-year, respectively) besides the high incidence of pre-diabetes and pre-hypertension (around 46 and 76 in men and 37 and 49 in women per 1000 person-year, respectively) showed a worrying situation. Fortunately, the results of the community interventions were promising with around 20% reduction in the risk of metabolic syndrome up to six years.ConclusionsThese precise detections of different outcomes in the TLGS provided valuable evidences for prediction and prevention of NCDs in Iran with some novelties in the middle-income countries in the world. The Tehran thyroid study (TTS) and the Tehran cardiometabolic genetic study (TCGS), conducted in the framework of the TLGS, are among few studies aiming to determine the natural course of thyroid function and to identify patterns of genetic polymorphisms related to cardiometabolic outcomes, respectively.

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“…Elevated FPG level has been comprehensively investigated as a core component in models for risk assessment of T2D 19,20 . Analysis of the Tehran Lipid and Glucose Study showed a positive association between changes in FPG levels and the incidence of T2D 21 . As expected, our results indicated that changes in FPG levels were most strongly associated with the development of T2D.…”

Section: Discussionmentioning

confidence: 97%

Changes in metabolic syndrome and its components and the risk of type 2 diabetes: a nationwide cohort study

Lee

Han

Kim

et al. 2020

Sci Rep

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We investigated the relationship of changes in Metabolic syndrome (MetS) and its components with the risk of type 2 diabetes (T2D) in South Korea. Records of 10,806,716 adults aged ≥ 20 years without a history of T2D between 2009 and 2015 were retrieved from database of the South Korean National Health Insurance Service and analyzed. Changes in metabolic components were monitored over a twoyear period with follow-up occurring at an average of 4.087 years. During the follow-up period, 848,859 individuals were diagnosed with T2D. The risk of diabetes was lowered with a decrease in the number of MetS components at baseline and the second visit (p for trend <0.0001). Multivariable-adjusted HRs for incident diabetes were 0.645 among individuals with reduced number of MetS components, 0.54 for those with improvement in elevated fasting glucose, 0.735 for those with improvement in elevated triglycerides, 0.746 for those with improvement in elevated blood pressure, 0.763 for those with improvement in reduced HDL-cholesterol, and 0.92 for those with improvement in abdominal obesity compared with those manifesting them at both time points. In conclusion, changes in metabolic syndrome and its components were significantly associated with the development of T2D. Improvement in MetS and its components attenuated the risk of diabetes. Type 2 diabetes (T2D) is a chronic disease resulting from a complex interaction between heredity and environment, along with other risk factors 1. Insulin resistance, obesity, and behavioral factors such as physical activity, diet, smoking, alcohol consumption, and body weight are important risk factors for T2D 2. Increasing incidence of diabetes and related complications imposes a heavy health burden 3. Thus, investigations should focus on effective interventions and preventive measures for the disease. Metabolic syndrome (MetS) was conceptualized based on a constellation of risk factors, such as elevated fasting plasma glucose (FPG), atherogenic dyslipidemia, elevated blood pressure, and abdominal obesity, in individuals susceptible to cardiovascular disease (CVD) and T2D 4. Guidelines for clinical and epidemiological management of MetS have been developed using readily available clinical variables 5. A number of studies have demonstrated a strong association of MetS and its components with the risk of incident T2D 6-8. Thus, clinical implications of MetS should be focused on multifactorial interventions to reduce the risk of T2D 9. All individuals deserve long-term management of MetS and follow-up in the clinical setting 10. However, cohort studies that correlate the development of T2D with changes in MetS and its components are lacking. Thus, the objective of this nationwide population-based cohort study was to investigate association of changes in MetS and its components with risk of T2D in South Korea.

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Change in fasting plasma glucose and incident type 2 diabetes mellitus: results from a prospective cohort study

Cited by 19 publications

References 41 publications

High genetic burden of type 2 diabetes can promote the high prevalence of disease: a longitudinal cohort study in Iran

High genetic burden of type 2 diabetes can promote the high prevalence of disease: a longitudinal cohort study in Iran

Outcomes in the Tehran Lipid and Glucose Study (TLGS) as a Longitudinal Population-Based Cohort Study and a Pragmatic Community Trial

Changes in metabolic syndrome and its components and the risk of type 2 diabetes: a nationwide cohort study

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