Cardiometabolic & kidneyCohort study
Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model
- Prospective cohort study
- multi-state model
Authors' conclusion
Pre-diabetes was the optimal intervention stage in the disease trajectory.
Study context
- Population
- Adults aged 20–88 free of coronary heart disease (CHD) and stroke at baseline (Jinchang Cohort)
- Participants
- 42,585 adults
- Outcome
- Transition rates from normoglycaemia to pre-diabetes, T2DM, CVD and CV death, and effects of risk factors on transition rates
- Follow-up
- Median 7 years
Main finding
As reported in the abstract
Transition rates (multistate model)
- Comorbid CHD and stroke → CV death (highest rate)
- 157.21/1000 person-years
- Stroke alone → CV death
- 69.31/1000 person-years
- Pre-diabetes → normoglycaemia
- 46.51/1000 person-years
- Pre-diabetes sojourn time
- 6.77 years
- T2DM → CHD alone
- 12.21/1000 person-years
- T2DM → stroke alone
- 12.16/1000 person-years
- Pre-diabetes → CHD alone
- 6.81/1000 person-years
- Pre-diabetes → stroke alone
- 4.93/1000 person-years
- Normoglycaemia → CHD alone
- 3.28/1000 person-years
- Normoglycaemia → stroke alone
- 2.39/1000 person-years
Observational data: associations, not effects.
Further findings
Incident events during follow-up · median follow-up 7 years
- Developed pre-diabetes
- 7498
- Developed T2DM
- 2307
- Developed cardiovascular diseases (CVD)
- 2499
- Died from CVD
- 324
Other risk factors
- Overweight/obesity, smoking, dyslipidaemia and hyperuricaemia played crucial but different roles in transitions
- Controlling weight, blood lipids, BP and uric acid within normal limits may promote reversion to normoglycaemia
Original publication
Progression from different blood glucose states to cardiovascular diseases: a prospective study based on multi-state model. Eur J Prev Cardiol. Published 14 June 2023. doi:10.1093/eurjpc/zwad196
Summarised from the published abstract; every number is checked against it