Prevalence and associated factors of diabetes and impaired fasting glucose in Chinese hypertensive adults aged 45 to 75 years

Xianhui Qin, Jianping Li, Yan Zhang, Wei Ma, Fangfang Fan, Binyan Wang, Houxun Xing, Genfu Tang, Xiaobin Wang, Xin Xu, Xiping Xu, Yong Huo, Xianhui Qin, Jianping Li, Yan Zhang, Wei Ma, Fangfang Fan, Binyan Wang, Houxun Xing, Genfu Tang, Xiaobin Wang, Xin Xu, Xiping Xu, Yong Huo

Abstract

Objective: This study examined the prevalence of impaired fasting glucose (IFG) and diabetes and their associated factors in 17,184 Chinese hypertensive adults aged 45-75 years.

Methods: A cross-sectional investigation was carried out in a rural area of Lianyungang, China. Previously undiagnosed diabetes [fasting plasma glucose (FPG) ≥ 7.0 mmol/l] and IFG (6.1-6.9 mmol/l) were defined based on FPG concentration. Previously diagnosed diabetes was determined on the basis of self-report. Total diabetes included both previously diagnosed diabetes and previously undiagnosed diabetes.

Results: The prevalence of previously diagnosed diabetes, undiagnosed diabetes, and IFG were 3.4%, 9.8%, and 14.1%, respectively. About 74.2% of the participants with diabetes had not previously been diagnosed. In the multivariable logistic-regression model, older age, men, antihypertensive treatment, obesity (BMI ≥ 25 kg/m(2)), abdominal obesity (waist circumference ≥ 90 cm for men and ≥ 80 cm for women), non-current smoking, a family history of diabetes, higher heart rate, lower physical activity levels, and inland residence (versus coastal) were significantly associated with both total diabetes and previously undiagnosed diabetes. Furthermore, methylene- tetrahydrofolate reductase (MTHFR) 677 TT genotype was an independent associated factor for total diabetes, and current alcohol drinking was an independent associated factor for previously undiagnosed diabetes. At the same time, older age, men, abdominal obesity, non-current smoking, current alcohol drinking, a family history of diabetes, higher heart rate, and inland residence (versus coastal) were important independent associated factors for IFG.

Conclusion: In conclusion, we found a high prevalence of diabetes in Chinese hypertensive adults. Furthermore, about three out of every four diabetic adults were undiagnosed. Our results suggest that population-level measures aimed at the prevention, identification (even if only based on the FPG evaluation), and treatment of diabetes should be urgently taken to overcome the diabetes epidemic in Chinese hypertensive adults.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. (2010) Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375: 2215–2222.
    1. Pan XR, Yang WY, Li GW, Liu J (1997) Prevalence of diabetes and its risk factors in China, 1994. Diabetes Care 20: 1664–1669.
    1. Gu D, Reynolds K, Duan X, Xin X, Chen J, et al. (2003) Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Disease in Asia (InterASIA). Diabetologia 46: 1190–1198.
    1. Yang W, Lu J, Weng J, Jia W, Ji L, et al. (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362: 1090–1101.
    1. Zhang L, Wang F, Wang L, Wang W, Liu B, et al. (2012) Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet 379: 815–822.
    1. Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ (2002) Selected major risk factors and global and regional burden of disease. Lancet 360: 1347–1360.
    1. Gu D, Reynolds K, Wu X, Chen J, Duan X, et al. (2002) Prevalence, awareness, treatment, and control of hypertension in China. Hypertension 40: 920–997.
    1. Iimura O (1996) Insulin resistance and hypertension in Japanese. Hypertens Res 19: S1–S8.
    1. Stamler J, Vaccaro O, Neaton JD, Wentworth D (1993) Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 16: 434–444.
    1. Qian X, Lu Z, Tan M, Liu H, Lu D (2007) A meta-analysis of association between C677T polymorphism in the methylenetetrahydrofolate reductase gene and hypertension. Eur J Hum Genet 15: 1239–1245.
    1. Holmes MV, Newcombe P, Hubacek JA, Sofat R, Ricketts SL, et al. (2011) Effect modification by population dietary folate on the association between MTHFR genotype, homocysteine, and stroke risk: a meta-analysis of genetic studies and randomised trials. Lancet 378: 584–594.
    1. Qin X, Li J, Cui Y, Liu Z, Zhao Z, et al. (2011) Effect of folic acid intervention on the change of serum folate level in hypertensive Chinese adults: do methylenetetrahydrofolate reductase and methionine synthase gene polymorphisms affect therapeutic responses? Pharmacogenet Genomics 22: 421–428.
    1. Qin X, Li J, Cui Y, Liu Z, Zhao Z, et al. (2012) MTHFR C677T and MTR A2756G Polymorphisms and the Homocysteine Lowering Efficacy of Different Doses of Folic Acid in Hypertensives Chinese Adults. Nutrition Journal 11: 2.
    1. Boffetta P, McLerran D, Chen Y, Inoue M, Sinha R, et al. (2011) Body mass index and diabetes in Asia: a cross-sectional pooled analysis of 900,000 individuals in the Asia cohort consortium. PLoS One 6: e19930.
    1. Feng Y, Hong X, Li Z, Zhang W, Jin D, et al. (2006) Prevalence of metabolic syndrome and its relation to body composition in a Chinese rural population. Obesity (Silver Spring) 14: 2089–2098.
    1. Zhang S, Liu X, Yu Y, Hong X, Christoffel KK, et al. (2009) Genetic and environmental contributions to phenotypic components of metabolic syndrome: a population-based twin study. Obesity (Silver Spring) 17: 1581–1587.
    1. Zhang X, Shu XO, Xiang YB, Yang G, Li H, et al. (2010) Resting heart rate and risk of type 2 diabetes in women. Int J Epidemiol 39: 900–906.
    1. World Health Organization Western Pacific Region, International Association for the Study of Obesity, International Obesity TaskForce. The Asia-Pacific Perspective: Redefining obesity and its treatment. Health Communications Australia Pty Limit, Australia.
    1. International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome. Available: .
    1. Department of Noncommunicable Disease Surveillance. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation. Part 1. Diagnosis and classification of diabetes mellitus. Geneva: World Health Organization.
    1. Sun Z, Zheng L, Xu C, Zhang X, Li J, et al. (2009) Prevalence of diabetes and impaired fasting glucose in hypertensive adults in rural China. Acta Cardiol 64: 351–356.
    1. Li LM, Rao KQ, Kong LZ, Yao CH, Xiang HD, et al. (2005) A description on the Chinese national and health survey in 2002. Zhonghua Liu Xing Bing Xue Za Zhi 26: 478–484.
    1. Mozaffarian D, Marfisi R, Levantesi G, Silletta MG, Tavazzi L, et al. (2007) Incidence of new-onset diabetes and impaired fasting glucose in patients with recent myocardial infarction and the effect of clinical and lifestyle risk factors. Lancet 370: 667–675.
    1. Njølstad I, Arnesen E, Lund-Larsen PG (1998) Sex differences in risk factors for clinical diabetes mellitus in a general population: a 12-year follow-up of the Finnmark Study. Am J Epidemiol 147: 49–58.
    1. Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J (2007) Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 298: 2654–2564.
    1. Benes P, Kanková K, Muzík J, Groch L, Benedík J, et al. (2001) Methylenetetrahydrofolate reductase polymorphism, type II diabetes mellitus, coronary artery disease, and essential hypertension in the Czech population. Mol Genet Metab 73: 188–195.
    1. Movva S, Alluri RV, Venkatasubramanian S, Vedicherla B, Vattam KK, et al. (2011) Association of methylene tetrahydrofolate reductase C677T genotype with type 2 diabetes mellitus patients with and without renal complications. Genet Test Mol Biomarkers 15: 257–261.
    1. Chang YH, Fu WM, Wu YH, Yeh CJ, Huang CN, et al. (2011) Prevalence of methylenetetrahydrofolate reductase C677T and A1298C polymorphisms in Taiwanese patients with Type 2 diabetic mellitus. Clin Biochem 44: 1370–1374.
    1. Belalcazar LM, Reboussin DM, Haffner SM, Reeves RS, Schwenke DC, et al. (2010) Marine omega-3 fatty acid intake: associations with cardiometabolic risk and response to weight loss intervention in the Look AHEAD (Action for Health in Diabetes) study. Diabetes Care 33: 197–199.
    1. Pedersen MH, Mølgaard C, Hellgren LI, Lauritzen L (2010) Effects of fish oil supplementation on markers of the metabolic syndrome. J Pediatr 157: 395–400.
    1. Shi Z (2010) Prevalence of diabetes among men and women in China N Engl J Med. 362: 2425.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir