INTRODUCTION: Studies of concordance between patients' self-report of diseases and a criterion standard (e.g. chart review) are usually conducted in epidemiological studies to evaluate the agreement of self-reported data for use in public health research. To our knowledge, there are no published studies on concordance for highly prevalent chronic diseases such as diabetes and pre-diabetes. The aims of this study were to evaluate the concordance between patients' self-report and their medical records of diabetes and pre-diabetes diagnoses, and to identify factors associated with diabetes concordance. METHOD: A cross-sectional, interviewer-administered survey was conducted on patients with chronic diseases after obtaining written consent to assess their medical notes. Interviewers were blinded to the participants' profiles. Concordance was evaluated using Cohen's kappa (κ). A multivariable logistic regression model was used to identify factors associated with diabetes concordance. RESULTS: There was substantial agreement between self-reported and medical records of diabetes diagnoses (κ=0.76) and fair agreement for pre-diabetes diagnoses (κ=0.36). The logistic regression model suggested that non-Chinese patients had higher odds of diabetes concordance than Chinese patients (odds ratio [OR]=4.10, 95% confidence interval [CI] 1.19-14.13, P=0.03). Patients with 3 or more chronic diseases (i.e. multimorbidity) had lower odds of diabetes concordance than patients without multimorbidity (OR=0.21, 95% CI 0.09-0.48, P<0.001). CONCLUSION Diabetes concordance was substantial, supporting the use of self-report of diabetes by patients with chronic diseases in the primary care setting for future research. Pre-diabetes concordance was fair and may have important clinical implications. Further studies to explore and improve health literacy and patient-physician communication are needed.
Humans ; Prediabetic State ; Singapore/epidemiology* ; Cross-Sectional Studies ; Diabetes Mellitus/epidemiology* ; Medical Records ; Self Report

Objective: To investigate the relationship between hemoglobin and serum uric acid in adults with various glucose metabolism status. Methods: The demographic data and biochemical indicators of the adult population who had received physical examination in the Second Medical Center of the PLA General Hospital from January 2018 to December 2021 were collected. The subjects were divided into two groups according to the level of serum uric acid: the normal uric acid group and the hyperuricemia group. The relationship between hemoglobin (stratified into four levels of Q₁ to Q₄ by the quartile) and serum uric acid was quantified by using Pearson correlation and logistic regression analysis. The effects of age and glucose metabolism status on the relationship between hemoglobin and serum uric acid were analyzed. Results: A total of 33 183 adults were enrolled with age (50.6±10.0) years. The level of hemoglobin in the normal uric acid group (142.61±14.24) g/L was significantly lower than that in the hyperuricemia group [(151.79±11.24) g/L, P<0.001]. Univariate Pearson correlation analysis showed that hemoglobin was positively associated with serum uric acid (r=0.444, P<0.001). After adjusting for related confounding factors, multivariate logistic regression analysis showed that hemoglobin was associated with serum uric acid, and the OR values (95%CI) of hemoglobin Q₂ to Q₄ group were 1.29 (1.13-1.48), 1.42 (1.24-1.62) and 1.51 (1.32-1.72), respectively (P_trend<0.001) when compared with hemoglobin Q₁ group. Subgroup analysis and hierarchical interaction analysis suggested that with the increase of hemoglobin, the serum uric acid in the age<60 years subgroup, normal glucose subgroup and prediabetes subgroup increased gradually (P_trend<0.05 and P_interaction<0.001). Conclusion: The association between hemoglobin and serum uric acid in adults is affected by age and glucose metabolism status.
Humans ; Adult ; Middle Aged ; Uric Acid ; Hyperuricemia/epidemiology* ; Hemoglobins ; Prediabetic State ; Glucose ; Risk Factors

OBJECTIVES: To investigate the prevalence of diabetes mellitus (DM) among Uygur children in Hotan Prefecture of Xinjiang, China, as well as the factors influencing the development of DM. METHODS: The cluster random sampling method was used to select 5 308 children, aged 4-18 years, from the middle and primary schools and kindergartens in Hotan Prefecture of Xinjiang. The survey methods included questionnaire survey and the measurement of height and weight. All subjects were tested for fasting fingertip blood glucose to investigate the prevalence of DM and impaired fasting glucose (IFG). RESULTS: A total of 5 184 valid questionnaires were collected. Fourteen children (0.27%) were found to have DM, among whom 8 had type 1 DM, 2 had type 2 DM, and 4 had unclassified DM. Twenty-nine children (0.56%) were found to have IFG. There was no significant difference in the prevalence rate of DM and IFG between boys and girls (P>0.05). The prevalence rate of DM was 0.18% in the 4-<10 years group, 0.47% in the 10-<15 years group, and 0.07% in the 15-18 years group (P=0.072).The prevalence rate of IFG in the above three age groups was 0.18%, 0.94%, and 0.42%, respectively, with a significant difference among groups (P=0.007). The proportion of family history of DM and the proportion of overweight/obesity in children with DM were significantly higher than those in children without DM (P<0.05), while the proportion of children with DM who preferred coarse grains was significantly lower than that in children without DM (P<0.05). CONCLUSIONS The prevalence of DM and IFG in Uyghur children in Hotan Prefecture of Xinjiang is relatively low. There is no significant difference in the prevalence of DM among children of different genders or age groups, but the prevalence of IFG in children of different age groups is different. A family history of DM, overweight or obesity, and low intake of coarse grains might be associated with the development of DM.
Adolescent ; Blood Glucose ; Child ; Child, Preschool ; China/epidemiology* ; Female ; Humans ; Male ; Pediatric Obesity ; Prediabetic State/epidemiology* ; Prevalence ; Risk Factors

Objective: To explore the incidence and influencing factors of prediabetes in adults in China. Methods: Ten provinces (cities) were selected from the surveillance survey of chronic diseases and their risk factors in China in 2010; two monitoring sites were selected from each province (city) as follow-up spots, and a follow-up survey was conducted from 2016 to 2017. An unconditional logistic regression model was used to analyze the influencing factors of prediabetes. Results: A total of 5 578 participants were included in this study. During the follow-up period, 612 patients (268 males and 344 females) developed impaired glucose tolerone (IGT), with a total follow-up of 37 364.82 person-years, and the incidence of IGT was 16.4/1 000 person-years. Impaired fasting glucose (IFG) occurred in 290 patients (128 males and 162 females) with a total follow-up of 39 731.31 person-years, and the incidence of IFG was 7.3/1 000 person-years. The multivariate unconditional logistic regression model included age, urban and rural areas, family history of diabetes, BMI, central obesity, dyslipidemia, hypertension, and physical activity, and the results showed that age (≥50 years old: OR=1.60, 95%CI: 1.32-1.95), urban residents (OR=1.41, 95%CI: 1.16-1.71), obesity (OR=1.56, 95%CI: 1.12-2.19), dyslipidemia (OR=1.52, 95%CI: 1.25-1.83), hypertension (OR=1.32, 95%CI: 1.07-1.61) and physical inactivity (OR=1.25, 95%CI: 1.04-1.50) increase the risk of IGT. Age (≥50 years old: OR=1.31, 95%CI: 1.01-1.70), family history of diabetes (OR=1.71, 95%CI: 1.13-2.60), overweight (OR=1.41, 95%CI: 1.04-1.92), obesity (OR=2.09, 95%CI: 1.38-3.17) and hypertension (OR=1.53, 95%CI: 1.18-2.00) increase the risk of IFG. Conclusions: The incidence of IGT is higher than the IFG. People aged 50 and above, overweight and obese people, hypertension patients, dyslipidemia patients, people with insufficient physical activity, and family history of diabetes are prone to prediabetic events.
Adult ; Female ; Male ; Humans ; Middle Aged ; Prediabetic State/epidemiology* ; Incidence ; Overweight ; Obesity ; Hypertension ; Glucose ; China/epidemiology*

Objective: To evaluate the relationship of serum uric acid with prediabetes and newly detected type 2 diabetes mellitus (T2DM) in adults. Methods: Data were obtained from the baseline investigation of Songjiang Peak-Plan cohort. According to the baseline fasting plasma glucose and glycosylated hemoglobin, the eligible subjects were divided into normal blood sugar group, prediabetes group, and newly detected T2DM group. Unconditional logistic regression model was used to explore the effect of serum uric acid level on prediabetes and newly detected T2DM, and restricted cubic spline (RCS) function was used to explore the nonlinear dose-response relationship of serum uric acid level with the prevalence of prediabetes and newly detected T2DM. Results: A total of 30 375 subjects were included in the analysis, with an average age of (55.36±11.52) years, and 60.2% (18 299) of them were women. The baseline survey found that the prevalence of prediabetes was 38.6% (11 739 cases), and the prevalence of newly detected T2DM was 6.6% (1 992 cases). Logistic regression analysis showed that, in women, for every 10µmol/L increase in serum uric acid, the risk of developing prediabetes and T2DM s increased by 2.4% (OR=1.024, 95%CI: 1.018-1.030), and 1.5% (OR=1.015, 95%CI: 1.005-1.025), respectively; in men, for every 10 µmol/L increase in serum uric acid, the risk of developing prediabetes and T2DM decreased by 0.8% (OR=0.992, 95%CI: 0.987-0.998) and 5.0% (OR=0.950, 95%CI: 0.939-0.960), respectively. The RCS function showed that the serum uric acid level showed a nonlinear dose-response relationship with newly detected T2DM (P=0.017), but not with prediabetes (P=0.670) in women and showed a nonlinear dose-response relationship with both prediabetes (P=0.040) and newly detected T2DM (P<0.001) in men. Conclusions: Adult women are at increased risk of prediabetes and newly detected T2DM with increase of serum uric acid level, and adult men are at decreased risk of newly diagnosed T2DM with the increase of serum uric acid level. There was no significant relationship between serum uric acid level and prediabetes in men.
Adult ; Male ; Female ; Humans ; Middle Aged ; Aged ; Prediabetic State/epidemiology* ; Uric Acid ; Diabetes Mellitus, Type 2/epidemiology* ; Glycated Hemoglobin ; Fasting

BACKGROUNDSeveral previous studies have shown that snoring is associated with glucose metabolism and the development of diabetes, but rare study has shown the association between snoring frequency and prediabetes, particularly in China. We hypothesized that individuals who snore might have a higher risk of prediabetes. This study aimed to investigate the association between self-reported snoring and prediabetes in a Chinese population.

METHODSA cross-sectional study was performed in three large communities of Beijing from December 2011 to August 2012 by recruiting individuals aged ≥40 years old. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. A 75 g oral glucose tolerance test was performed in individuals without diabetes. Blood samples of all participants were collected; blood glucose and blood fat levels were measured. Multivariate logistic regression models were built to assess the association between snoring frequency and prediabetes.

RESULTSA total of 13,592 participants (female: 66.56%; mean age: 56.8 ± 7.9 years; mean body mass index: 25.5 ± 3.4 kg/m2) were included in the final analysis. Of these, 30.9% were diagnosed with prediabetes, while 41.3% and 25.4% had occasional and habitual snoring, respectively. Habitual snoring was associated with an increased risk of prediabetes (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1-1.4, P< 0.001), after adjusting for diabetes and sleep-related confounders in the multivariable models. Habitual snoring was also associated with isolated impaired fasting glucose (IFG; OR: 1.3, 95% CI: 1.0-1.6; P< 0.001) and isolated impaired glucose tolerance (IGT; OR: 1.3, 95% CI: 1.2-1.5; P< 0.001), but not IFG + IGT (OR: 1.1, 95% CI: 0.9-1.4; P = 0.281). When stratified by total cholesterol (TC) levels, this association between habitual snoring and prediabetes was observed only in individuals with TC <5.6 mmol/L (OR: 1.4, 95% CI: 1.2-1.6; P< 0.001).

CONCLUSIONSHabitual snoring is associated with prediabetes, but only in individuals with TC <5.6 mmol/L. Further prospective studies are needed to confirm this finding.

Adult ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Cross-Sectional Studies ; Diabetes Mellitus ; blood ; epidemiology ; Fasting ; blood ; Female ; Glucose Intolerance ; blood ; epidemiology ; etiology ; Humans ; Male ; Middle Aged ; Odds Ratio ; Prediabetic State ; blood ; epidemiology ; etiology ; Self Report ; Snoring ; blood ; complications ; epidemiology

The rapid increases in childhood obesity and physical inactivity are linked to the incidence of diabetes among young individuals. However, few studies have evaluated the prevalence of diabetes among this population. Therefore, we used Korea National Health and Nutrition Examination Survey (KNHANES) data to evaluate the prevalence and management of diabetes and pre-diabetes among young Koreans. We evaluated KNHANES data (2005–2014) from 10–29-year-old individuals. Individuals were considered eligible if they had completed the health examination and the health interview survey, and we excluded individuals with missing data regarding fasting glucose or glycated haemoglobin levels. Among the 100,101 potentially eligible individuals who participated in KNHANES (2005–2014), we included 83,577 (37,677 male and 45,900 female) individuals. The overall prevalences of diabetes and pre-diabetes among 10–19-year-old individuals were 0.2% and 11.9%, respectively. Among 20–29-year-old individuals, the prevalences of diabetes and pre-diabetes were 0.9% and 9.6%, respectively. The overall rates of diabetes awareness during the study period were 36.6% for 10–19-year-old individuals and 50.8% for 20–29-year-old individuals. However, the prevalence of diabetes and pre-diabetes had noticeably increased at the 2013–2014 KNHANES: 0.6% and 25.9% among 10–19-year-old individuals, and 0.8% and 19.2% among 20–29-year-old individuals. The prevalence of diabetes and pre-diabetes is rapidly increasing among Korean teenagers and young adults. Pre-emptive interventions to diagnose and treat diabetes and pre-diabetes are needed to improve glycaemic control among this population.
Adolescent* ; Diabetes Mellitus ; Epidemiology ; Fasting ; Glucose ; Health Care Surveys ; Humans ; Incidence ; Korea* ; Male ; Nutrition Surveys* ; Pediatric Obesity ; Prediabetic State ; Prevalence* ; Young Adult*

Objective: To investigate the prevalence of erectile dysfunction (ED) in men with pre-diabetes. METHODS: This study included 500 men with impaired fasting glycaemia (IFG), 500 with impaired glucose tolerance (IGT), and another 500 with normal blood glucose (NBG), all from Lanzhou. We conducted a questionnaire investigation among the subjects using the International Index of Erectile Dysfunction 5 (IIEF-5). RESULTS: The prevalence rates of ED in the IFG, IGT, and NBG groups were 14.8%, 29.2%, and 33.2%, respectively. After controlling for age, nationality, occupation, education, income, obesity, and blood pressure, the incidence rate was markedly higher in the IFG and IGT than in the NBG group (29.2% and 33.2% vs 14.8%, P <0.05), but showed no statistically significant difference between the IFG and IGT groups (P >0.05). CONCLUSIONS The prevalence of ED is higher in men with pre-diabetes than in those with normal blood glucose in Lanzhou.
Blood Glucose ; Blood Pressure ; China ; epidemiology ; Diabetes Mellitus ; Erectile Dysfunction ; epidemiology ; etiology ; Ethnic Groups ; Glucose Intolerance ; epidemiology ; Humans ; Male ; Obesity ; epidemiology ; Prediabetic State ; complications ; Prevalence ; Surveys and Questionnaires

OBJECTIVEThis study aimed to investigate the epidemiology of diabetes in adults from Shanghai, aged 35 and older, in 2013.

METHODSWe estimated the diabetes prevalence in a representative sample of 18,736 adults who were selected through a multistage stratified cluster sampling process. A standard questionnaire containing questions about demographic characteristics and lifestyle factors was distributed. After an overnight fast of at least 10 hours, a venous blood sample was collected from each participant. For each patient without a history of diabetes, another blood sample was drawn 120 min after an oral glucose tolerance test to identify undiagnosed diabetes and prediabetic condition.

RESULTSAmong Shanghai residents aged 35 and above, the overall weighted prevalence of diabetes was 17.6% [95% confidence interval (CI): 16.4%-18.8%]. The prevalences were 19.3% in men and 15.8% in women as well as 19.1%, 15.4%, and 16.1% in urban, suburban, and rural residents, respectively. In addition, the weighted prevalence of prediabetes was 16.5% (95% CI: 15.3%-17.8%), with the prevalences of 16.5% in men, 16.6% in women, 15.2% in urban residents, 18.0% in suburban residents, and 18.5% in rural residents. Among all patients with diabetes, 68.1% (95% CI: 64.3%-71.6%) were aware of their status, 63.5% (95% CI: 60.0%-66.9%) received diabetes treatment, but only 35.1% (95% CI: 32.4%-37.8%) had adequate glycemic control.

CONCLUSIONIn Shanghai, diabetes and prediabetes are highly prevalent. However, 1/3rd of diabetes cases are undiagnosed, and the rate of glycemic control is low.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; etiology ; Female ; Glucose Tolerance Test ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Prediabetic State ; epidemiology ; etiology ; Prevalence ; Risk Factors ; Rural Population ; Socioeconomic Factors ; Urban Population ; statistics & numerical data

OBJECTIVETo investigate the prevalence of chronic kidney disease (CKD) in subjects with different glucose metabolism status.

METHODSBetween January, 2015 and October, 2015, a total of 934 subjects without a previous diagnosis of diabetes visiting the Department of Endocrinology or Health Examination Center underwent oral glucose tolerance test (OGTT), which identified 266 subjects with normal glucose tolerance (NGT group), 243 pre-diabetic subjects, and 425 patients with diabetes mellitus group. The baseline characteristics and laboratory test data of the subjects were collected. The diagnosis of CKD was established for an eGFR <60 mL/min/1.73 m(2) or a ACR≥30 mg/g, and the prevalence of CKD were compared among the 3 groups. Logistic regression model was used to analyze the OR value of the risk factors of CKD.

RESULTSThe prevalences of CKD in NGT, pre-diabetic and diabetic groups were 10.2%, 26.3% and 32.5%, respectively. Pairwise comparisons showed that the prevalence of CKD was significantly higher in pre-diabetic group (P<0.001, OR=3.17, 95% CI 1.94-5.17) and diabetic group (P<0.001, OR=4.27, 95% CI 2.72-6.65) than in NGT group, and was comparable between the pre-diabetic and diabetic groups (P=0.115, OR=1.35, 95% CI 0.95-1.91). Logistic regression analysis, after adjustment for age, gender, blood pressure, hypertension, blood lipids and uric acid, showed that pre-diabetes (OR=2.03, P=0.044) and diabetes mellitus (OR=2.22, P=0.016) were independently associated with CKD.

CONCLUSIONGlucose metabolism status has a significant independent impact on the incidence of CKD, suggesting the importance of early detection of pre-diabetes and timely interventions in pre-diabetic subjects in prevention CKD.

Diabetes Mellitus ; epidemiology ; Glucose ; metabolism ; Glucose Tolerance Test ; Humans ; Incidence ; Prediabetic State ; epidemiology ; Prevalence ; Renal Insufficiency, Chronic ; epidemiology ; Risk Factors