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Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model
2023-10-10
Online publication date2023-06
Source PublicationEuropean Journal of Preventive Cardiology   Impact Factor & Quartile
ISSN2047-4873 ; 2047-4881
Volume30Issue:14Pages:1482-1491
page numbers10
AbstractAims To quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), and cardiovascular death, and the effects of risk factors on the rates of transition. Methods and results We used data from the Jinchang Cohort of 42 585 adults aged 20-88 free of coronary heart disease (CHD) and stroke at baseline. A multistate model was applied for analysing the progression of CVD and its relation to various risk factors. During a median follow-up of 7 years, 7498 participants developed pre-diabetes, 2307 developed T2DM, 2499 developed CVD, and 324 died from CVD. Among 15 postulated transitions, transition from comorbid CHD and stroke to cardiovascular death had the highest rate (157.21/1000 person-years), followed by transition from stroke alone to cardiovascular death (69.31/1000 person-years) and transition from pre-diabetes to normoglycaemia (46.51/1000 person-years). Pre-diabetes had a sojourn time of 6.77 years, and controlling weight, blood lipids, blood pressure, and uric acid within normal limits may promote reversion to normoglycaemia. Among transitions to CHD alone and stroke alone, transition from T2DM had the highest rate (12.21/1000 and 12.16/1000 person-years), followed by transition from pre-diabetes (6.81/1000 and 4.93/1000 person-years) and normoglycaemia (3.28/1000 and 2.39/1000 person-years). Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions. Conclusion Pre-diabetes was the optimal intervention stage in the disease trajectory. The derived transition rates, sojourn time, and influence factors could provide scientific support for the primary prevention of both T2DM and CVD. Lay summary Former single-outcome studies on the relationship between glycaemia and cardiovascular disease (CVD) may ignore the complexity and multi-transformations across the multiple stages from normoglycaemia to CVD in real-world setting. We aimed to quantify the trajectories from normoglycaemia to pre-diabetes, subsequently to type 2 diabetes, CVD, and cardiovascular death.Pre-diabetes was the optimal intervention stage in the disease trajectory.Transitions from CVD to death had much higher rates than other transitions.Age and hypertension were associated with an accelerated rate for most transitions. Overweight/obesity, smoking, dyslipidaemia, and hyperuricaemia played crucial but different roles in transitions.
KeywordType 2 diabetes Pre-diabetes Cardiovascular disease Progression Multi-state model Prospective cohort study
PublisherOXFORD UNIV PRESS
DOI10.1093/eurjpc/zwad196
Indexed BySCIE
Language英语
WOS Research AreaCardiovascular System & Cardiology
WOS SubjectCardiac & Cardiovascular Systems
WOS IDWOS:001027763300001
Original Document TypeArticle
PMID 37315161
Citation statistics
Cited Times:1[WOS]   [WOS Record]     [Related Records in WOS]
Document Type期刊论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/568977
Collection兰州大学
公共卫生学院
Corresponding AuthorCheng, Zhiyuan; Bai, Yana
Affiliation
1.Lanzhou Univ, Inst Epidemiol & Stat, Sch Publ Hlth, 199 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;
2.Southern Univ Sci & Technol, Sch Publ Hlth & Emergency Management, 1088 xueyuan St, Shenzhen 518055, Guangdong, Peoples R China;
3.Jinchuan Grp CO LTD, WorkersHospital Jinchuan Corp, 53 Beijing Rd, Jinchang 737100, Gansu, Peoples R China
First Author AffilicationSchool of Public health
Corresponding Author AffilicationSchool of Public health
Recommended Citation
GB/T 7714
Chen, Yarong,Xu, Lulu,Cheng, Zhiyuan,et al. Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model[J]. European Journal of Preventive Cardiology,2023,30(14):1482-1491.
APA Chen, Yarong.,Xu, Lulu.,Cheng, Zhiyuan.,Zhang, Desheng.,Yang, Jingli.,...&Bai, Yana.(2023).Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model.European Journal of Preventive Cardiology,30(14),1482-1491.
MLA Chen, Yarong,et al."Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model".European Journal of Preventive Cardiology 30.14(2023):1482-1491.
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