The influence of prehypertension, hypertension, and glycated hemoglobin on the development of type 2 diabetes mellitus in prediabetes: the Korean Genome and Epidemiology Study (KoGES)
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It has been reported that elevated blood pressure (BP) was significantly associated with the increased risk for type 2 diabetes mellitus (T2DM). However, there is still limited information about the influence of BP on the risk for T2DM across the level of glycated hemoglobin (HbA1c).
In a cohort of the Korean Genome and Epidemiology Study (KoGES), 2830 non-diabetic Korean adults with prediabetes defined by HbA1c level of 5.7–6.4% were followed-up for 10 years. Multivariate cox proportional hazards assumption was used to assess the risk for T2DM according to the baseline BP categories (normal, prehypertension and hypertension) and HbA1c level (low: 5.7–5.9% and high: 6.0–6.4%).
The risk for T2DM significantly increased proportionally to BP categories (adjusted HR; reference in normal BP, 1.32 [1.10–1.59] in prehypertension and 1.61 [1.35–1.92] in hypertension). Subgroup analysis indicated that individuals with high HbA1c had the higher risk for T2DM than individuals with low HbA1c regardless of BP. Additionally, combined presence of hypertension and high HbA1c had the highest risk for T2DM (adjusted HR: 3.82 [3.00–4.87]). In each systolic and diastolic BP level, the risk for T2DM significantly increased from systolic BP ≥ 130 mmHg (adjusted HRs: 1.39 ([1.15–1.71]) and diastolic BP ≥ 80 mmHg (adjusted HRs: 1.30 ([1.07–1.58]).
BP and HbA1c may be useful tools in identifying individuals with prediabetes more potentially predisposed to T2DM. Prospective studies should be considered to examine whether controlling BP actually lowers the risk for T2DM.
KeywordsType 2 diabetes mellitus Blood pressure HbA1c Prehypertension Hypertension
Data in this study were from the Korean Genome and Epidemiology Study (KoGES; 4851-302), National Research Institute of Health, Centers for Disease Control and Prevention, Ministry for Health and Welfare, Republic of Korea. Therefore, this study could be done by virtue of the labor of all staffs working in KoGES.
All authors had access to the data used in this study and participated in writing the manuscript. J.Y.J. coordinated the study, analyzed the data, and wrote the manuscript as a first author. C.M.O. played role in analyzing data and verifying the results. J.H.R. participated in conducting study and writing manuscript. J.-M.C. conducted english editing and reviewing manuscript. Y.-J.C. played a role in monitoring study process and making manuscript. W.T.H. took part in revising manuscript. S.K.P. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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