Impact of the longitudinal evolution of impaired fasting glucose on cardio-kidney-metabolic multimorbidity.
To characterize longitudinal impaired fasting glucose (IFG) evolution patterns and evaluate their associations with the risk of incident cardio-kidney-metabolic (CKM) multimorbidity.
In this prospective cohort study, 43,073 adults from the Kailuan Study who underwent examinations in 2006 and 2010 and were free of cardiovascular disease, type 2 diabetes, and chronic kidney disease at baseline were included. IFG status was classified as sustained normal, progression, recovery, or persistent IFG. Participants were followed through 2021. The primary outcome was multimorbidity, defined as ≥2 of the following: cardiovascular disease, type 2 diabetes, or chronic kidney disease. Multivariable Cox models estimated adjusted hazard ratios (HRs).
Over a median follow-up of 11.0 years, 1,795 participants developed CKM multimorbidity. Compared with sustained normal fasting glucose, adjusted HRs (95% CIs) were 1.93 (1.72-2.17) for IFG progression, 1.69 (1.44-1.98) for IFG recovery, and 3.10 (2.74-3.52) for persistent IFG. Using IFG recovery as the reference, risks remained lower for sustained fasting glucose health (HR 0.59; 95% CI 0.51-0.69), whereas persistent IFG remained associated with a higher risk (HR 1.84; 95% CI 1.55-2.18). The association for IFG progression was attenuated and no longer statistically significant (HR 1.14; 95% CI 0.97-1.35).
Individuals who recover from IFG have a lower risk than those with persistent or progressive IFG, yet their risk remains higher than that of individuals with sustained fasting glucose health. These findings highlight that preventing the onset of IFG should be the optimal strategy, followed by timely intervention after its occurrence to mitigate long-term multisystem damage.
In this prospective cohort study, 43,073 adults from the Kailuan Study who underwent examinations in 2006 and 2010 and were free of cardiovascular disease, type 2 diabetes, and chronic kidney disease at baseline were included. IFG status was classified as sustained normal, progression, recovery, or persistent IFG. Participants were followed through 2021. The primary outcome was multimorbidity, defined as ≥2 of the following: cardiovascular disease, type 2 diabetes, or chronic kidney disease. Multivariable Cox models estimated adjusted hazard ratios (HRs).
Over a median follow-up of 11.0 years, 1,795 participants developed CKM multimorbidity. Compared with sustained normal fasting glucose, adjusted HRs (95% CIs) were 1.93 (1.72-2.17) for IFG progression, 1.69 (1.44-1.98) for IFG recovery, and 3.10 (2.74-3.52) for persistent IFG. Using IFG recovery as the reference, risks remained lower for sustained fasting glucose health (HR 0.59; 95% CI 0.51-0.69), whereas persistent IFG remained associated with a higher risk (HR 1.84; 95% CI 1.55-2.18). The association for IFG progression was attenuated and no longer statistically significant (HR 1.14; 95% CI 0.97-1.35).
Individuals who recover from IFG have a lower risk than those with persistent or progressive IFG, yet their risk remains higher than that of individuals with sustained fasting glucose health. These findings highlight that preventing the onset of IFG should be the optimal strategy, followed by timely intervention after its occurrence to mitigate long-term multisystem damage.
Authors
Chen Chen, Zheng Zheng, Wang Wang, Gui Gui, He He, Chen Chen, Wu Wu, Chen Chen
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