Prediabetes, Diabetes, and the Risk of All-Cause and Cause-Specific Mortality in a Japanese Working Population: Japan Epidemiology Collaboration on Occupational Health Study

Author:

Islam Zobida1ORCID,Akter Shamima1,Inoue Yosuke1,Hu Huan1ORCID,Kuwahara Keisuke12,Nakagawa Tohru3,Honda Toru3,Yamamoto Shuichiro3,Okazaki Hiroko4,Miyamoto Toshiaki5,Ogasawara Takayuki6,Sasaki Naoko6,Uehara Akihiko7,Yamamoto Makoto8,Kochi Takeshi9,Eguchi Masafumi9,Shirasaka Taiki9,Shimizu Makiko10,Nagahama Satsue11,Hori Ai12,Imai Teppei13,Nishihara Akiko14,Tomita Kentaro15,Sone Tomofumi16,Konishi Maki1,Kabe Isamu17,Mizoue Tetsuya1,Dohi Seitaro4

Affiliation:

1. Department of Epidemiology and Prevention, National Center for Global Health and Medicine, Tokyo, Japan

2. Graduate School of Public Health, Teikyo University, Tokyo, Japan

3. Hitachi Health Care Center, Hitachi Ltd., Ibaraki, Japan

4. Mitsui Chemicals, Inc., Tokyo, Japan

5. Nippon Steel Corporation, East Nippon Works, Chiba, Japan

6. Mitsubishi Fuso Truck and Bus Corporation, Kanagawa, Japan

7. Seijinkai Shizunai Hospital, Hokkaido, Japan

8. Yamaha Corporation, Shizuoka, Japan

9. Furukawa Electric Co., Ltd., Tokyo, Japan

10. Mizue Medical Clinic, Keihin Occupational Health Center, Kanagawa, Japan

11. All Japan Labour Welfare Foundation, Tokyo, Japan

12. Department of Global Public Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan

13. OH Support, Kanagawa, Japan

14. Azbil Corporation, Tokyo, Japan

15. Healthplant Co., Ltd., Tokyo, Japan

16. National Institute of Public Health, Saitama, Japan

17. Kubota Corporation, Tokyo, Japan

Abstract

OBJECTIVE Prediabetes has been suggested to increase risk for death; however, the definitions of prediabetes that can predict death remain elusive. We prospectively investigated the association of multiple definitions of prediabetes with the risk of death from all causes, cardiovascular disease (CVD), and cancer in Japanese workers. RESEARCH DESIGN AND METHODS The study included 62,785 workers who underwent a health checkup in 2010 or 2011 and were followed up for death from 2012 to March 2019. Prediabetes was defined according to fasting plasma glucose (FPG) or glycated hemoglobin (HbA1c) values or a combination of both using the American Diabetes Association (ADA) or World Health Organization (WHO)/International Expert Committee (IEC) criteria. The Cox proportional hazards regression model was used to investigate the associations. RESULTS Over a 7-year follow-up, 229 deaths were documented. Compared with normoglycemia, prediabetes defined according to ADA criteria was associated with a higher risk of all-cause mortality (hazard ratio [HR] 1.53; 95% CI 1.12–2.09) and death due to cancer (HR 2.37; 95% CI 1.45–3.89) but not with death due to CVD. The results were materially unchanged when prediabetes was defined according to ADA FPG, ADA HbA1c, WHO FPG, or combined WHO/IEC criteria. Diabetes was associated with the risk of all-cause, CVD, and cancer deaths. CONCLUSIONS In a cohort of Japanese workers, FPG- and HbA1c-defined prediabetes, according to ADA or WHO/IEC, were associated with a significantly increased risk of death from all causes and cancer but not CVD.

Funder

Japan Society for the Promotion of Science

National Center for Global Health and Medicine

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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