Relative role of major risk factors for Type 2 diabetes development in the historical cohort of the Brisighella Heart Study: an 8‐year follow‐up

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Abstract
Aim The aim of this study was to evaluate and quantify the role of different risk factors in the long‐term development of Type 2 diabetes mellitus in a rural Italian population. Methods The Brisighella Heart Study (BHS; 1972–2003) is a prospective, population‐based longitudinal epidemiological cohort involving 2939 randomly selected subjects, aged 14–84 years, resident in the rural Italian town of Brisighella. For this study, we randomly selected 1441 adult subjects representative of the Brisighella population; consecutively visited during three BHS surveys. A step‐wise Cox regression analysis determined the prognostic significance of each independent risk factor for the development of Type 2 diabetes in the 8‐year long follow‐up. Results Blood pressure, high‐density lipoprotein cholesterol, triglycerides, physical activity, total energy intake, and drug treatment had no effect on the incidence of diabetes. Age was a significant predictor of Type 2 diabetes when inserted alone in the model (P = 0.007), but irrelevant when adjusted for baseline body mass index (BMI) and or fasting plasma glucose. Among these with impaired fasting glucose (IFG), the diabetes incidence/year was estimated to be 6.6% for men and 11.2% for women (P < 0.001). Basal glycaemia under 6.1 mmol/l were not significant long‐term predictors of diabetes development, while higher basal glycaemia and each level BMI were. Conclusion Our findings confirm that IFG and BMI predict Type 2 diabetes development in our population. This should help to identify effective approaches to prevention.