Publication details

The Prevalence of Dysglycemia-Based Chronic Disease in a European Population - a New Paradigm to Address Diabetes Burden: A Kardiovize Study

Authors

GONZALEZ-RIVAS J. P. MECHANICK J. I. INFANTE-GARCIA M. M. MEDINA-INOJOSA J. R. PAVLOVSKA Iuliia HLINOMAZ Ota ŽÁK Petr KUNZOVA Sarka NIETO-MARTINEZ R. SKLADANA Maria BROZ Jan HERNANDEZ J. P. LOPEZ-JIMENEZ F. STOKIN G. B.

Year of publication 2021
Type Article in Periodical
Magazine / Source Endocrine Practice
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.sciencedirect.com/science/article/pii/S1530891X20483600?via%3Dihub
Doi http://dx.doi.org/10.1016/j.eprac.2020.10.003
Keywords cardiovascular disease; diabetes; epidemiology; type 2 diabetes mellitus
Description Objective: To determine the prevalence rate and associated risk factors for each stage of the Dysglycemia-Based Chronic Disease (DBCD) model, which 4 distinct stages and prompts early prevention to avert Diabetes and cardiometabolic complications. Methods: Subjects between 25 and 64 years old from a random population-based sample were evaluated in Czechia from 2013 to 2014 using a cross-sectional design. DBCD stages were: stage 1 "insulin resistance" (inferred risk from abdominal obesity or a family history of diabetes); stage 2 "prediabetes"(fasting glucose between 5.6 and 6.9 mmol/L); stage 3 "type 2 diabetes (T2D)" (self-report of T2D or fasting glucose >= 7 mmol/L); and stage 4 "vascular complications" (T2D with cardiovascular disease). Results: A total of 2147 subjects were included (57.8% women) with a median age of 48 years. The prevalence of each DBCD stage were as follows: 54.2% (stage 1); 10.3% (stage 2), 3.7% (stage 3); and 1.2% (stage 4). Stages 2 to 4 were more frequent in men and stage 1 in women (P < .001). Using binary logistic regression analysis adjusting by age/sex, all DBCD stages were strongly associated with abnormal adiposity, hypertension, dyslipidemia, and smoking status. Subjects with lower educational levels and lower income were more likely to present DBCD. Conclusion: Using the new DBCD framework and available metrics, 69.4% of the population had DBCD, identifying far more people at risk than a simple prevalence rate for T2D (9.2% in Czechia, 2013-2014). All stages were associated with traditional cardiometabolic risk factors, implicating common pathophysiologic mechanisms and a potential for early preventive care. The social determinants of health were related with all DBCD stages in alarming proportions and will need to be further studied. (C) 2020 AACE. Published by Elsevier Inc.

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