Reversion From Pre–Diabetes Mellitus to Normoglycemia and Risk of Cardiovascular Disease and All‐Cause Mortality in a Chinese Population: A Prospective Cohort Study

Abstract

Background It is unclear whether reversion from pre–diabetes mellitus to normoglycemia reduces cardiovascular disease (CVD) and all‐cause mortality risk in a Chinese population. We aimed to fill this research gap. Methods and Results The current study included 14 231 Chinese participants (mean age, 58.08 years) who were free from myocardial infarction and stroke at the time of survey participation (2006–2007 and 2008–2009). Participants were divided into 3 categories according to the 2‐year changes in pre–diabetes mellitus, defined by fasting plasma glucose: those with progression to diabetes mellitus, those with reversion from pre–diabetes mellitus to normoglycemia, and those with persistent pre–diabetes mellitus. Cox proportional hazards models were used to calculate hazard ratios (HRs) and their 95% CIs for CVD and all‐cause mortality. After a median follow‐up period of 8.75 years, a total of 879 CVD events (including 180 myocardial infarction events and 713 stroke events) and 941 all‐cause mortality events were recorded. After adjustment for confounding factors, reversion from pre–diabetes mellitus to normoglycemia was associated with decreased risks of CVD (HR, 0.78; 95% CI, 0.64–0.96), myocardial infarction (HR, 0.62; 95% CI, 0.40–0.97), stroke (HR, 0.79; 95% CI, 0.63–0.98), and all‐cause mortality (HR, 0.82; 95% CI, 0.68–0.99) compared with progression to diabetes mellitus. Conclusions Reversion from fasting plasma glucose–defined pre–diabetes mellitus to normoglycemia was associated with a reduction in the future risk of CVD and all‐cause mortality in a Chinese population. Registration URL: https://www.chictr.org; Unique identifier: ChiCTRTNC‐11001489.

Keywords

• all‐cause death
• cardiovascular disease
• diabetes mellitus
• myocardial infarction
• normoglycemia
• pre–diabetes mellitus