Prediabetes remission and cardiovascular morbidity and mortality: post-hoc analyses from the Diabetes Prevention Program Outcome study and the DaQing Diabetes Prevention Outcome study

作者：Elsa Vazquez Arreola, Qiuhong Gong, Robert L. Hanson, Jinping Wang, Leontine Sandforth, Siyao He, Arvid Sandforth, Xin Qian, Mauro Giacca, Stefan R. Bornstein, Andreas Fritsche, Norbert Stefan, Hubert Preißl, Edward W. Gregg, Nikolaus Marx, Reiner Jumpertz von Schwartzenberg, Guangwei Li, Andreas L. Birkenfeld · 发表于：The Lancet Diabetes & Endocrinology · 年份：2025 · DOI：10.1016/s2213-8587(25)00295-5 · 被引用次数：17 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Diabetes Treatment and Management、Bariatric Surgery and Outcomes

BACKGROUND: Prediabetes is associated with increased risk of cardiovascular disease and heart failure. Multicomponent lifestyle interventions, including diet and physical activity targeting weight loss are recommended for prediabetes management, although their long-term impact on cardiovascular outcomes remains unclear. Reaching prediabetes remission by restoring normal glucose regulation has been shown to profoundly reduce future type 2 diabetes risk outlasting the time of lifestyle intervention. We aimed to investigate whether prediabetes remission is associated with a lower incidence of cardiovascular death or hospitalisation for heart failure compared with non-remission, with a long-term legacy effect. METHODS: Post-hoc analyses were performed from two landmark diabetes prevention trials, the US Diabetes Prevention Program Outcomes Study (DPPOS) and the Chinese DaQing Diabetes Prevention Outcomes Study (DaQingDPOS). Remission was assessed using the American Diabetes Association criteria after 1 year (DPPOS) or 6 years (DaQingDPOS) of intervention. The primary endpoint was cardiovascular death or hospitalisation for heart failure over 20 and 30 years, respectively. In DPPOS, inverse probability of treatment weighting adjusted for baseline differences. A unifying meta-analysis was calculated across both data sets for the primary endpoint and all-cause mortality. FINDINGS: For DPPOS, follow-up time is reported from the start of the original Diabetes Prevention Program trial,...