Association of prediabetes with the risks of adverse health outcomes and complex multimorbidity: an observational study

Abstract

Abstract Background As an abnormal state of glucose metabolism, prediabetes may cause serious damage to human health like diabetes, but it is often ignored in public health management. Here, we aim to evaluate prediabetes as a risk factor for common diseases across body system and assess whether prediabetes poses a health hazard like diabetes. Methods We conducted an observational study using data from the National Inpatient Sample (NIS) database from 2016 to 2018. A total of 16,650,296 patients were collected from NIS database, and 76 common diseases of various body systems were selected for analysis based on previous literature. Logistic regression model and further in-depth subgroup analysis were used to estimate the relationship between prediabetes and the risk of 76 health outcomes and prediabetes-related multimorbidity. Main results: Among 116,779 patients with prediabetes, the mean age was 61.4 years, 60,440 (51.8%) were female and 72,322 (64.2%) were white. Prediabetes mellitus was associated with the risk of 22 nonoverlapping diseases with significant multiple test results and odds ratios (ORs) greater than 1.50. Compared with normoglycemia, the adjusted OR for prediabetes was 4.74 (4.63–4.85) for accompanying two prediabetes-related diseases (i.e., simple multimorbidity), and 11.74 (11.43–12.05) for four or more diseases (i.e., complex multimorbidity). The proportion of older people (≥ 65 years of age) increases with the increase of number of prediabetes-related diseases. Conclusions Prediabetes was associated with a significantly higher risk of co-existing multiple adverse health outcomes and multimorbidity. Prediabetes, thus, might represent an important target for multimorbidity prevention, and stronger emphasis on its management and reduction seems necessary to reduce the risk of the development of multiple comorbidities, especially before the onset of overt diabetes.