Xing Wu, Zhexin Yu, Wen Su, Daniel A Isquith, Moni B Neradilek, Ning Lu, Fusheng Gu, Hongwei Li and Xue-Qiao Zhao
Aims: Type-2 diabetes mellitus (T2DM) has become a major public health crisis in China. We examined the incidence of new T2DM over 4 years for association of clinical factors and lipids with development of T2DM in a community-based population. Methods: We included 923 Chinese subjects who participated in community-organized health checkout in both 2009 and 2013. Health history was collected; physical examination was performed; biochemistry, lipids and glucose were measured. Of 923, 819 were confirmed without T2DM in 2009 and included in the analysis. Results: Sixty-five subjects without T2DM in 2009 were identified as having new T2DM in 2013, 8% (65/819) over 4 years. These 65 subjects, compared to those 754 without new T2DM, were older, more likely to be male and smokers. They had higher BMI, fasting glucose, blood pressure and triglycerides, and lower levels of HDL-C and ApoA1. Multivariate logistic regression identified larger BMI (OR=1.7, 95%CI 1.22-2.39, p=0.002), higher fasting glucose (OR=4.2, 95%CI 2.90-6.19, p<0.001) and low levels of ApoA1 (OR=0.51, 95%CI 0.33-0.76, p=0.002) were independently associated with development of T2DM over 4 years. ROC curves for new T2DM showed that AUC improved from 0.87 to 0.89 when adding ApoA1 to the Framingham Diabetes Risk Model and from 0.85 to 0.89 when adding ApoA1 to a Chinese model. Conclusions: This study showed a high incidence of new T2DM at 8% over 4 years among Chinese and demonstrated a significant and independent association of higher BMI and glucose levels, and lower levels of ApoA1 with development of T2DM.