Risk Factors for Development of Pre-Diabetic State from Normal Glucose Regulation

Risk Factors for Development of Pre-Diabetic State from Normal Glucose Regulation

MICHIKO ORISAKA,^1,2 KENJI NAKAI,² MAKOTO TOMINAGA³ and AKIRA SUWABE²

¹Iwate Health Service Association, Morioka, Japan, ²Department of Laboratory Medicine, Iwate Medical University School of Medicine, Morioka, Japan, ³Department of Laboratory Medicine, Yamagata University School of Medicine, Yamagata, Japan

As a strategy to prevent the progression of diabetes mellitus, it is important to screen out the subjects who will develop a pre-diabetic state (PDS) in the future. To find out the potential risk factors for PDS, we employed the values of fasting plasma glucose and hemoglobin A1c (HbA1c), which are routinely measured in our health checkup. We selected 3,879 individuals who had normal glucose regulation at both fasting plasma glucose < 6.1 mmol/l and HbA1c < 5.5% in 1997 and investigated whether they would develop PDS in the next 5 years. PDS is defined at fasting plasma glucose ≥ 6.1 mmol/l and HbA1c ≥ 5.5%. Among 3,879 individuals, 21 developed PDS and 2,128 maintained normal glucose regulation in 2001. The remaining 1,730 subjects fit one of the two criteria for PDS. The parameters measured in 1997, including fasting plasma glucose, HbA1c, triglyceride, alanine aminotransferase, γ-glutamyltranspeptidas, cholinesterase, uric acid, red blood cells, hemoglobin, percent body fat and diastolic blood pressure, were significantly higher in the individuals who developed PDS than in those who maintained normal glucose regulation. On the other hand, hematocrit was significantly lower in PDS than in normal glucose regulation. Logistic regression analysis identified alanine aminotransferase ≥ 40 U/l, triglyceride ≥ 1.69 mmol/l, low-density lipoprotein cholesterol ≥ 3.62 mmol/l and hematocrit < 38% as valuable factors for predicting the development of PDS. The present study demonstrates that the subjects with high risks for PDS could be identified from several clinical parameters and that they should be encouraged to improve their living habits not to develop diabetes mellitus.

keywords —— glucose; diabetes mellitus; pre-diabetic state; lifestyle; laboratory data

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Tohoku J. Exp. Med., 2006, 210, 279-283

Correspondence: Michiko Orisaka, Ph.D., Iwate Health Service Association, 14-42 Nagai, Morioka, Iwate 020-8585, Japan.

e-mail: mi-orisaka@mvf.biglobe.ne.jp