Prediabetes and intermediate hyperglycemia prevalence in adults and associated factors, Health National Survey

Iser, Betine Pinto Moehlecke; Pinheiro, Pedro Cisalpino; Malta, Deborah Carvalho; Duncan, Bruce Bartholow; Schmidt, Maria Inês

doi:10.1590/1413-81232021262.34852020

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ARTICLE • Ciênc. Saúde Colet. 26 (02) • Feb 2021 • https://doi.org/10.1590/1413-81232021262.34852020 copy

Prediabetes and intermediate hyperglycemia prevalence in adults and associated factors, Health National Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to evaluate the prevalence of prediabetes and intermediate hyperglycemia in Brazilian adults, according to different diagnostic criteria, and establish associated factors to its occurrence. We analyzed the National Health Survey laboratory data collected from 2014 to 2015. The prevalence of the conditions was calculated according to the American Diabetes Association (ADA) diagnostic criteria based on glycated hemoglobin (HbA1c) 5.7%-6.4%, and the World Health Organization (WHO) 6-6.4%, among those without criteria for diabetes. Crude and adjusted prevalence rates (PR) and 95% CI were calculated using Poisson regression with robust variance. The prevalence of prediabetes by ADA and WHO criteria was 18.5 and 7.5%, respectively. We observed a gradient of increased prevalence by the age of the population and risk factors, like arterial hypertension, obesity, elevated waist circumference, and low HDL cholesterol levels. Less educated people and the self-declared black had a higher prevalence. This study pointed out a range from 7.5 to 18.5% of Brazilian adults with prediabetes and intermediate hyperglycemia and identified a risk score to this condition’s occurrence.

Key words:
Hyperglycemia; Prediabetic state; Glycated Hemoglobin A; Epidemiological surveys; Risk factors

Criteria / Cutoff points	ADA / SBD	WHO / IDF / IEC	All
	Prediabetes	Intermediate Hyperglycemia	Diabetes
Fasting blood glucose	100-125 mg/dL* (5.6-6.9 mmol/L)	110-125 mg/dL (6.1-6.9 mmol/L)	126 mg/dL (< 7.0 mmol/L)
Oral glucose tolerance test (OGTT) 2h after 75g glucose overload	140-199 mg/dL (7.8-11.0 mmol/L)^#	140 e 199 mg/dl (7.8-11.0 mmol/L)^#	≥ 200 mg/dL (11.1 mmol/L)
Glycated hemoglobin (HbA1c)	5.7 - 6.4% (39-47 mmol/mol)	6 - 6.4% (42-47 mmol/mol)	≥ 6.5% (48 mmol/mol)

Variables	ADA: 5.7-6.4%			WHO: 6-6.4%
Variables	Prev. % (95% CI)	PRcrude	PRadj^∞	Prev. (95% CI)	PRcrude	PRadj^∞
Total	18.5 (17.4-19.7)	-	-	7.5 (6.7-8.3)	-	-
Gender
Male	17.2 (15.6-19)	1	1	7.0 (5.9-8.3)	1	1
Female	19.7 (18.2-21.2)	1.14*	0.99	7.9 (6.9-9)	1.12	0.9
Age group
18-39	7.8 (6.6-9.2)	1	1	2.2 (1.6-3.1)	1	1
40-59	20.4 (18.5-22.4)	2.62*	2.15*	7.8 (6.6-9.3)	3.5*	2.53*
≥60 years	37.6 (34.7-40.5)	4.82*	3.63*	17.9(15.6-20.4)	7.98*	4.83*
Schooling
No education to elementary	22 (20.4-23.6)	1	1	9.8 (8.6-11)	1	1
Secondary complete and over	14.5 (13-16.3)	0.66*	0.95	4.9 (4-5.9)	0.5*	0.79
Ethnicity/skin color
White	18.8 (17.1-20.6)	1	1	7.3 (6.3-8.6)	1	1
Black	26.7 (22.3-31.6)	1.42*	1.5*	13.8 (10.3-18.4)	1.89*	2.07*
Brown	16.2 (14.8-17.7)	0.86*	0.97	6.2 (5.4-7.3)	0.85	1.04
Other	25.9 (14.7-41.5)	1.38	1.51	8.6 (2.6-25.3)	1.18	1.36
Region
North	14.6 (13-16.3)	1	1	5.3 (4.4-6.5)	1	1
Northeast	16.4 (15-17.9)	1.13	1.02	5.8 (4.9-6.7)	1.08	0.95
Southeast	20.6 (18.5-22.9)	1.42*	1.19*	9.1 (7.7-10.8)	1.71*	1.4*
South	16.7 (14.4-19.3)	1.15	0.97	6.8 (5.4-8.6)	1.28	1.07
Midwest	20.2 (17.5-23.2)	1.39*	1.26*	7.0 (5.4-9.1)	1.31	1.18
BMI
Underweight/normal	12.4 (11-14)	1	1	4.8 (3.8-5.9)	1	1
Overweight	19.8 (17.9-21.8)	1.59*	1.27*	7.9 (6.7-9.3)	1.65*	1.19
Obesity	29.3 (26.4-32.4)	2.35*	1.65*	12.7 (10.7-15)	2.67*	1.54*
Waist circumference
Normal	13 (11.8-14.4)	1	1	4.5 (3.8-5.4)	1	1
High	27.7 (25.7-29.8)	2.13*	1.2*	12.4 (11-14.1)	2.73*	1.51*
Hypertension					0
No	12.6 (11.5-13.9)	1	1	4.2 (3.5-5)	1	1
Yes	30 (27.8-32.4)	2.38*	1.32*	14.0 (12.3-15.9)	3.35*	1.55*
HDL Cholesterol
Recommended	15.2 (13.8-16.8)	1	1	5.9 (5-6.9)	1	1
Low	22 (20.3-23.8)	1.45*	1.28*	9.2 (8.1-10.5)	1.57*	1.35*
Physical inactivity					0
Inactive	20.2 (18.8-21.6)	1	1	8.3 (7.4-9.4)	1	1
Insufficiently active	14.6 (11.4-18.5)	0.72*	0.87	7.6 (5.3-10.7)	0.91	1.16
Active	15 (12.9-17.4)	0.75*	0.96	5.0 (3.9-6.6)	0.61*	0.85
Consumption of fruits and vegetables
Adequate/Regular	18.4 (16.5-20.5)	1	1	7.6 (6.4-9.2)	1	1
Low	18.5 (17.2-20)	1.01	1.11	7.4 (6.5-8.4)	0.97	1.05

Variables	ADA			WHO
Variables	Prev. % (95% CI)	PRcrude	PRadj^∞	Prev. (95% CI)	PRcrude	PRadj^∞
One factor	9.1 (7.0-11.8)	1	1	2.4 (1.4-4.1)	1	1
Two factors	12.0 (10.2-14.0)	1.31	1.13	4.3 (3.3-5.7)	1.82	1.49
3-4 factors	22.3 (20.5-24.2)	2.44*	1.76*	9.1 (7.9-10.5)	3.82*	2.49*
Five factors and over	35.9 (32.1-39.9)	3.93*	2.56*	17.2 (14.3-20.6)	7.23*	4.13*

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Collaborations

BPM Iser participated in the conception and design of the study, organization, analysis, and interpretation of the data, and was responsible for the first version of the manuscript. PC Pinheiro was responsible for data extraction and analysis, contributed to their interpretation, and drafting of the manuscript. DC Malta, BB Duncan and MI Schmidt contributed to the study’s conception and design, analysis, and interpretation of the data and participated in scientific writing. All authors approved the final version to be published and are responsible for its content.