title: Modifiable risk factors associated with prediabetes in men and women: a cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes (PREDAPS-Study).
abstract: BACKGROUND
  Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women.
  
  
  METHODS
  Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models.
  
  
  RESULTS
  Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24).
  
  
  CONCLUSIONS
  Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population.
authors.affiliation: Department of Preventive Medicine and Public Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain. aliciadiazredondo@gmail.com.
authors.forename: Alicia
authors.initials: A
authors.lastname: Díaz-Redondo
authors.affiliation: Department of Preventive Medicine, Public Health (History of Science), Universidad Complutense de Madrid, Madrid, Spain. cvalle.giraldez@gmail.com.
authors.forename: Carolina
authors.initials: C
authors.lastname: Giráldez-García
authors.affiliation: La Victoria de Acentejo Health Centre, Santa Cruz de Tenerife, Spain. lourdescarrillofernandez@gmail.com.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Carrillo
authors.affiliation: Martin de Vargas Health Centre, Madrid, Spain. rosarioserranom@gmail.com.
authors.forename: Rosario
authors.initials: R
authors.lastname: Serrano
authors.affiliation: Porriño Health Centre, Pontevedra, Spain. javiersoidan@gmail.com.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: García-Soidán
authors.affiliation: Hereza Health Centre, Madrid, Spain. sara.artola@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Artola
authors.affiliation: Raval-Sud Primary Care Team, Barcelona, Spain. josep.franch@gmail.com.
authors.forename: Josep
authors.initials: J
authors.lastname: Franch
authors.affiliation: Tafalla Health Centre, Navarra, Spain. javierdiezesp@ono.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Díez
authors.affiliation: Zumaia Health Centre, Guipúzcua, Spain. pezkurral@gmail.com.
authors.forename: Patxi
authors.initials: P
authors.lastname: Ezkurra
authors.affiliation: Torrero-La Paz Health Centre, Zaragoza, Spain. jmmillaruelo@gmail.com.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Millaruelo
authors.affiliation: Es Castell Basic Health Unit, Islas Baleares, Spain. mseguid5@gmail.com.
authors.forename: Mateu
authors.initials: M
authors.lastname: Seguí
authors.affiliation: Torrero-La Paz Health Centre, Zaragoza, Spain. sangrosconte@telefonica.net.
authors.forename: Javier
authors.initials: J
authors.lastname: Sangrós
authors.affiliation: Yecla Health Centre, Murcia, Spain. juanmartinezcandela@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Martínez-Candela
authors.affiliation: Family & Community Medicine Teaching Unit, Cantabria, Spain. pedro.munoz@scsalud.es.
authors.forename: Pedro
authors.initials: P
authors.lastname: Muñoz
authors.affiliation: Endocrinology & Nutrition Department, Del Mar Hospital, Barcelona, Spain. 88565@parcdesalutmar.cat.
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.affiliation: Department of Preventive Medicine, Public Health (History of Science), Universidad Complutense de Madrid, Madrid, Spain. enriqueregidor@hotmail.com.|Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain. enriqueregidor@hotmail.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
mesh_terms: D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology; D011236:Prediabetic State / Q000453:epidemiology* / Q000628:therapy; D011320:Primary Health Care; D012907:Smoking / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL