title: Pre-diabetes tsunami: incidence rates and risk factors of pre-diabetes and its different phenotypes over 9 years of follow-up.
abstract: To investigate the incidence of pre-diabetes and its different phenotypes and the related risk factors during 9 years of follow-up.
  
  
  
  A total of 5879 people (2597 men and 3282 women) aged ≥ 20 years, free of diabetes and pre-diabetes, took part in the study. Multivariable Cox proportional hazard models were used to evaluate hazard ratios (HR) and 95% confidence intervals (CI) for all potential risk factors.
  
  
  
  Overall, 853 men and 902 women developed pre-diabetes. Incidence rates of pre-diabetes were 46.1 per 1000 person-years in men and 36.8 per 1000 person-years in women, while isolated impaired fasting glucose had the highest incidence rate among all pre-diabetes phenotypes. In both sexes, age, family history of diabetes, fasting plasma glucose and 2-hour post-challenge plasma glucose were related to incident pre-diabetes. Among women, waist-to-height ratio [HR: 1.02 (1.00-1.03)] and being divorced/widowed compared with married [HR: 0.67 (0.52-0.87)] were significant predictors of pre-diabetes; whereas among men, community-based intervention [HR: 0.79 (0.68-0.90)], higher level of education and being single [HR: 0.77 (0.6-0.97)] were protective against progression to pre-diabetes. Moreover, hip circumference among women [HR: 0.95 (0.93-0.98)] and current smoking among men [HR: 1.69 (1.15-2.48)] were related to incident combined impaired fasting glucose and impaired glucose tolerance.
  
  
  
  More than 4% of the Iranian population develop pre-diabetes each year, emphasizing the important role of socio-economic factors (marital status, education and smoking habits) and community-based intervention in progression to impaired glucose regulations. Thus, emergent intervention is necessary to halt the tsunami of pre-diabetes among the Iranian population.
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: F
authors.initials: F
authors.lastname: Hadaegh
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: A
authors.initials: A
authors.lastname: Derakhshan
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: N
authors.initials: N
authors.lastname: Zafari
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: D
authors.initials: D
authors.lastname: Khalili
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: M
authors.initials: M
authors.lastname: Mirbolouk
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: N
authors.initials: N
authors.lastname: Saadat
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences (RIES), Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: F
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D019456:Health Transition; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D017533:Marital Status / Q000208:ethnology; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D065927:Waist-Height Ratio; D055815:Young Adult