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The heterogeneity of reversion to normoglycemia according to prediabetes type is not explained by lifestyle factors

2021; Nature Portfolio; Volume: 11; Issue: 1 Linguagem: Inglês

10.1038/s41598-021-87838-z

2045-2322

Carolina Giráldez‐García, Lucía Cea Soriano, Romana Albaladejo, Josep Franch‐Nadal, Manel Mata‐Cases, Javier Díez‐Espino, Sara Artola, Rosario Serrano, Enrique Regidor, Margarita Alonso, Beatriz Álvarez, Fernando Álvarez Guisasola, Juan Carlos Álvarez, Ma del Mar Álvarez, Joaquín Antón, Oriol Armengol, Luis Ávila, Carmen Babace, Lourdes Barutell, Ma Jesús Bedoya, B. Benito, Beatriz Bilbeny, M Birulés, Concepción Blanco, Ma Isabel Bobé, Carmen Boente, Antonia Borras, Remei Bosch, Ma Jesús Brito, Pilar Buil, J José Cabré, Ainoha Cambra, F Carbonell, Francisco Carramiñana, Lourdes Carrillo, Ana Casorrán, Rafael Colás, Blanca Cordero, Xavier Cos, Gabriel Cuatrecasas, Cristina De Castro, Manuel de la Flor, Carlos de la Sen, Rosa Mar de Miguel, Ana Santiago, Mercedes del Castillo, Ma Carmen Durán-Ruiz, Patxi Ezkurra, Paula Gabriel, Javier Gamarra, Francisco García, Luis García-Giralda, Francisco Javier García Soidán, Ma Teresa Gijón, Albert Goday, Ángel Gómez, María del Carmen Gómez, J. Carles González, María González, Esteban Granero, Ángela Trinidad Gutiérrez, Félix Gutiérrez, Luisa Gutiérrez Gutiérrez, Mario Gutiérrez, Ana Ma Hernández, Mercedes Ibáñez, Rosario Iglesias, Dimas Igual, Jaime Innenaraty, Yon Iriarte, Ángeles Jurado, Rafael Llanes, Flora López, Riánsares López, Ángela Lorenzo, Carmen Losada, Ramón Macía, Fernando Malo, José Mancera, Ma José Mansilla, Ma Teresa Marín, José Luis Fernández Martín, F. Javier Martínez, Juan Martínez, Rosario Martínez, Ma Soledad Mayayo, Javier Mediavilla, Luis Mendo, J. Manuel Millaruelo, Alicia Monzón, Ana Hernández Moreno, Pedro Muñoz, Xavier Mundet, Teresa Mur, Emma Navarro, Jorge Navarro, Pedro Nogales, Juan Carlos Obaya, Francisco Javier Medrano Ortega, Francisca Paniagua, José Luis Pardo, Francisco Carlos Pérez, Pedro P. Pérez, Neus Piulats, Raquel Plana, Núria Porta, Santiago Póveda, Luis Prieto, Ramón M. Pujol, Jazmín Ripoll, Antonio Rodríguez‐Poncelas, Juan José Ramos Rodríguez, Ma Angeles Rollán, Laura Romera, Jóse Félix Rubio, Antonio Ruíz, Irene Ruíz, Manuel Antonio Ruiz, Isabel Sáenz, Julio Sagredo, Alejandro Salanova, L. Gabriel Sánchez, Manuel Sánchez, Gloria Sanz, Mateu Seguí, Dulce Suárez, Eduard Tarragó, Jesús Torrecilla, Jose Torres, Merè Villaró, Carmen Yuste,

Diabetes Treatment and Management

Abstract Healthy lifestyle interventions and drug therapies are proven to have a positive preventative influence on normal glucose regulation in prediabetes. However, little is known on the specific role that these factors play on reversion to normal glycemia according to type of prediabetes. We used data from the Observational prospective cohort study, The Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes from 2012 to 2015. A total of 1184 individuals aged 30–74 years old were included and classified based on the ADA in three mutually exclusive groups using either fasting plasma glucose (FPG) levels (from 100 to 125 mg/dl, FPG group), HbA 1c (5.7–6.4%, HbA1c group) or both impaired parameters. Information on lifestyle factors and biochemical parameters were collected at baseline. Reversion to normal glucose regulation was calculated at third year of follow-up. Relationship of lifestyle factor and type of prediabetes with reversion were estimated using odds ratios (ORs) with 95% confidence intervals (95% CIs) adjusting by different groups of confounders. Proportion of reversion rates were 31% for FPG group, 31% for HbA1c group and 7.9% for both altered parameters group, respectively. Optimal life style factors such as BMI < 25 kg/m 2 [OR (95% CI): 1.90 (1.20–3.01)], high adherence to Mediterranean diet 1.78 (1.21–2.63) and absence of abdominal obesity 1.70 (1.19–2.43) were the strongest predictors for reversion to normal glucose. However, those did not modify the ORs of reversion to normal glucose. Taking as reference those with both impaired parameters, subjects with FPG impairment (FPG group) had an OR of 4.87 (3.10–7.65) and 3.72 (2.39–5.78) for HbA1c group. These estimates remained almost the same after further adjustment for biochemical parameters and lifestyle factors (4.55(2.84–7.28) and 3.09 (1.92–4.97), respectively). Optimal lifestyle factors showed to be a positive predictor for reversion to normal glucose regulation however, the differences of reversion risk according type of prediabetes are not explained by lifestyle factors.