Abstract
Objective: To clarify factors associated with the new-onset (DM-new) or remission (DM-rem) of diabetes mellitus (DM).
Methods: The generalized-estimating-equation logistic model (GEE-L) was applied to periodic health check-up data of subjects aged 40-65 as of April 2008, who had repeatedly visited our facility from fiscal 2008 to 2013, to perform a longitudinal analysis of factors associated with DM-new or DM-rem. Diabetic was defined as diabetic type or diabetes according to JDSG-2013, or medication for DM. Also, fasting plasma glucose level less than 110mg/dL and/or HbA1c value less than 6.0% was defined as normal. DM-new and DM-rem were defined, respectively, as shift from normal to diabetic or diabetic to normal (without any medication for DM). Once DM-new or DM-rem had been determined, the subject was excluded from further analyses. Possible explanatory factors associated with DM-new or DM-rem also analyzed included medication with antihyperlipidemic drugs (AHLPD), gender, age, body mass index (BMI), and familial aggregation of DM (FADM).
Results: Of 37,981 and 3,935 subjects determined to be normal and diabetic, respectively, 769 and 421 subjects were observed to shift to DM-new and DM-rem, respectively. GEE-L analyses revealed that all five factors were significantly associated with DM-new, and BMI reduction or FADM had significant positive or negative associations with DM-rem, while there was no significant association between AHLPD and DM-rem.
Conclusion: AHLPD and another four factors raised the risk of DM-new. Although FADM may inhibit DM-rem, AHLPD may not significantly affect DM-rem. BMI reduction was important for remission of DM.
