title: Impaired fasting glucose, ancestry and waist-to-height ratio: main predictors of incident diagnosed diabetes in the Canary Islands.
abstract: OBJECTIVE
  To estimate the incidence rate and risk factors for diabetes in the Canary Islands.
  
  
  METHODS
  A total of 5521 adults without diabetes were followed for a median of 3.5 years. Incident cases of diabetes were self-declared and validated in medical records. The following factors were assessed by Cox regression to estimate the hazard ratios for diabetes: impaired fasting glucose (5.6 mmol/l ≤ fasting glucose ≤ 6.9 mmol/l), BMI, waist-to-height ratio (≥ 0.55), insulin resistance (defined as triglycerides/HDL cholesterol ≥ 3), familial antecedents of diabetes, Canarian ancestry, smoking, alcohol intake, sedentary lifestyle, Mediterranean diet, social class and the metabolic syndrome.
  
  
  RESULTS
  The incidence rate was 7.5/10(3) person-years (95% CI 6.4-8.8). The greatest risks were obtained for impaired fasting glucose (hazard ratio 2.6; 95% CI 1.8-3.8), Canarian ancestry (hazard ratio 1.9; 95% CI 1.0-3.4), waist-to-height ratio (hazard ratio 1.7; 95% CI 1.1-2.5), insulin resistance (hazard ratio 1.5; 95% CI 1.0-2.2) and paternal history of diabetes (hazard ratio 1.5; 95% CI 1.0-2.3). The metabolic syndrome (hazard ratio 1.9; 95% CI 1.3-2.8) and BMI ≥ 30 kg/m(2) (hazard ratio 1.7; 95% CI 1.0-2.7) were significant only when their effects were not adjusted for impaired fasting glucose and waist-to-height ratio, respectively.
  
  
  CONCLUSIONS
  The incidence of diabetes in the Canary Islands is 1.5-fold higher than that in continental Spain and 1.7-fold higher than in the UK. The main predictors of diabetes were impaired fasting glucose, Canarian ancestry, waist-to-height ratio and insulin resistance. The metabolic syndrome predicted diabetes only when its effect was not adjusted for impaired fasting glucose. In individuals with Canarian ancestry, genetic susceptibility studies may be advisable. In order to propose preventive strategies, impaired fasting glucose, waist-to-height ratio and triglyceride/HDL cholesterol should be used to identify subjects with an increased risk of developing diabetes.
authors: Primary Care Research Unit and Nuestra Señora de la Candelaria University Hospital, Tenerife, Canary Islands, Spain. acableo@gobiernodecanarias.org
authors: A Cabrera
authors: AC
authors: de León
authors: S Domínguez
authors: SD
authors: Coello
authors: D Almeida
authors: DA
authors: González
authors: B Brito
authors: BB
authors: Díaz
authors: J C del Castillo
authors: JC
authors: Rodríguez
authors: A González
authors: AG
authors: Hernández
authors: A
authors: A
authors: Aguirre-Jaime
authors: M del Cristo Rodríguez
authors: Mdel C
authors: Pérez
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001786:Blood Glucose / Q000378:metabolism*; D001827:Body Height; D015992:Body Mass Index; D038441:Diet, Mediterranean; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D010375:Pedigree; D011159:Population Surveillance; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects; D012923:Social Class; D013030:Spain / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose