METHODS: Cross-sectional retrospective analysis of medical records from a clinical center in Chile (2000-2007). OGTT was obtained from any patient with 1 cardiometabolic risk factor (CMRF) independent of age and body mass index.
RESULTS: In total, 4969 adults (mean age ± SD) 45.7 ± 15.9 years and 509 youths 16.6 ± 3.0 years were included. The prevalence (%, 95% CI) of prediabetes doubled that of T2D in youths (14.1%, 1.4-17.4 vs 6.3%, 4.5-8.7) and tripled it in adults (36.0%, 34.7-37.4 vs 10.7%, 9.8-11.5). In underweight and normal-weight adults, 22% (12.0-36.7) and 29.2% (26.4-32.1) had prediabetes, whereas 4.9% (1.3-16.1) and 8.8% (7.2-10.7) had T2D, respectively. In normal weight youths, 10.5% (6.7-15.9) and 2.9% (1.2-6.6) had prediabetes and T2D, respectively. In adults, but not in youths, most dysglycemia categories were related to overweight/obesity.
CONCLUSIONS: This study supports a public health policy to identify more people at risk for cardiovascular disease by implementing a revised case finding protocol for dysglycemia using OGTT in even normal weight patients over 6 years of age when there is at least 1 CMRF. Reanalysis of case finding protocols for cardiometabolic risk in other populations is warranted.
方法:对智利一家临床中心(2000-2007)的病历进行横断面回顾性分析。OGTT来自任何具有一个心脏代谢危险因素(CMRF)的患者,与年龄和BMI无关。
结果:总计,包括4,969名成年人(平均年龄±SD)45.7±15.9岁和509名年轻人16.6±3.0岁。患病率(%,95CI)的糖尿病前期是青少年T2D的两倍(14.1%,1.4-17.4vs.6.3%,4.5-8.7),并在成年人中增加了两倍(36.0%,34.7-37.4vs.10.7%,9.8-11.5)。在体重不足和体重正常的成年人中,22%(12.0-36.7)和29.2%(26.4-32.1)患有糖尿病前期,4.9%(1.3-16.1)和8.8%(7.2-10.7)患有T2D,分别。在体重正常的年轻人中,10.5%(6.7-15.9)和2.9%(1.2-6.6)患有糖尿病前期和T2D,分别。在成年人中,但不是在年轻人,大多数血糖异常类别与超重/肥胖有关.
结论:这项研究支持一项公共卫生政策,通过在至少有一个CMRF的6岁以上体重正常的患者中使用OGTT实施经修订的血糖异常病例发现方案,来识别更多的心血管疾病风险人群。有必要对其他人群中心脏代谢风险的病例发现方案进行重新分析。