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Abstract
The aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11–9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846–0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.
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1 University of the Basque Country UPV/EHU, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Leioa, Spain (GRID:grid.11480.3c) (ISNI:0000000121671098); Instituto de Salud Carlos III, CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427)
2 University of the Basque Country UPV/EHU, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Leioa, Spain (GRID:grid.11480.3c) (ISNI:0000000121671098); Osakidetza, Endocrinology and Nutrition Department, Cruces University Hospital, Bilbao, Spain (GRID:grid.426049.d) (ISNI:0000 0004 1793 9479)
3 University of the Basque Country UPV/EHU, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Leioa, Spain (GRID:grid.11480.3c) (ISNI:0000000121671098)
4 Osakidetza, Clinical Chemistry Laboratory, Cruces University Hospital, Bilbao, Spain (GRID:grid.426049.d) (ISNI:0000 0004 1793 9479)
5 University of the Basque Country UPV/EHU, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Leioa, Spain (GRID:grid.11480.3c) (ISNI:0000000121671098); Instituto de Salud Carlos III, CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427); Osakidetza, Endocrinology and Nutrition Department, Cruces University Hospital, Bilbao, Spain (GRID:grid.426049.d) (ISNI:0000 0004 1793 9479)