Regression to normoglycemia, progression to diabetes, and their association with health outcomes in Chinese adults with untreated prediabetes

doi:10.4239/wjd.124090

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Oct 15, 2026; 17(10): 124090
Published online Oct 15, 2026. doi: 10.4239/wjd.124090

Table 1 Baseline characteristics of the participants, n (%)

Characteristics	Total	Regression to normoglycemia	Progression to diabetes	Persistent prediabetes	P value
Number of participants	2461	530 (21.5)	373 (15.2)	1558 (63.3)
Baseline FPG (mmol/L), mean (SD)	6.0 (0.4)	5.9 (0.3)	6.1 (0.4)	6.0 (0.4)	< 0.001
Baseline HbA1c (%), mean (SD)	5.2 (0.4)	5.0 (0.4)	5.4 (0.4)	5.2 (0.4)	< 0.001
Age (years), mean (SD)	59.0 (8.6)	57.7 (8.6)	60.1 (8.8)	59.2 (8.4)	< 0.001
Age category
45-59 years	1375 (55.9)	331 (62.5)	191 (51.2)	853 (54.7)	0.001
≥ 60 years	1086 (44.1)	199 (37.5)	182 (48.8)	705 (45.3)
Males	1133 (46.0)	283 (53.4)	145 (38.9)	705 (45.3)	< 0.001
Married	2080 (84.5)	457 (86.2)	306 (82.0)	1317 (84.5)	0.230
Education level: High school or above	217 (8.8)	60 (11.3)	28 (7.5)	129 (8.3)	0.064
Total household income (CNY)
< 10000	777 (50.3)	171 (51.5)	128 (51.6)	478 (49.5)	0.744
≥ 10000	768 (49.7)	161 (48.5)	120 (48.4)	487 (50.5)
Health insurance
No	114 (4.6)	32 (6.0)	13 (3.5)	69 (4.4)	0.165
Yes	2339 (95.4)	497 (94.0)	359 (96.5)	1483 (95.6)
Current smokers	678 (27.9)	152 (28.8)	94 (25.7)	432 (28.1)	0.563
Current alcohol drinkers	454 (18.5)	106 (20.0)	57 (15.3)	291 (18.7)	0.19
Physical activity
Active	958 (38.9)	198 (37.4)	136 (36.5)	624 (40.1)	0.312
Other	1503 (61.1)	332 (62.6)	237 (63.5)	934 (59.9)
BMI (kg/m²)
< 24	1206 (56.0)	297 (62.9)	135 (40.5)	774 (57.4)	< 0.001
≥ 24 (overweight/obese)	947 (44.0)	175 (37.1)	198 (59.5)	574 (42.6)
Self-rated current health status
Poor/very poor	647 (26.3)	138 (26.0)	118 (31.7)	391 (25.1)	0.034
Very good/good/fair	1811 (73.7)	392 (74.0)	254 (68.3)	1165 (74.9)
Disease status
Hypertension	712 (29.0)	147 (27.9)	156 (41.8)	409 (26.3)	< 0.001
Dyslipidemia	270 (11.2)	48 (9.2)	72 (19.6)	150 (9.8)	< 0.001
CVD	365 (14.9)	72 (13.6)	83 (22.3)	210 (13.6)	< 0.001
Number of comorbidities
0	1588 (64.5)	330 (62.3)	225 (60.3)	1033 (66.3)	0.045
≥ 1	873 (35.5)	200 (37.7)	148 (39.7)	525 (33.7)
High-sensitivity C-reactive protein (mg/L), mean (SD)	2.5 (6.8)	1.9 (4.3)	3.4 (7.6)	2.6 (7.3)	0.008
Baseline FPG category
5.6-6.0 mmol/L	1310 (55.1)	338 (65.0)	139 (38.7)	833 (55.6)	< 0.001
6.1-6.9 mmol/L	1067 (44.9)	182 (35.0)	220 (61.3)	665 (44.4)
Baseline HbA1c category
5.7%-5.9%	92 (35.0)	9 (52.9)	25 (31.6)	58 (34.7)	0.246
6.0%-6.4%	171 (65.0)	8 (47.1)	54 (68.4)	109 (65.3)

FPG: Fasting plasma glucose; HbA1c: Glycated hemoglobin; CNY: Chinese yuan; CVD: Cardiovascular disease; BMI: Body mass index.

Full Size Table

Table 2 Binary logistic regression analysis of the factors associated with regression to normoglycemia and progression to diabetes from prediabetes

Factors	Regression to normoglycemia		Progression to diabetes
Factors	Adjusted OR (95%CI)^a	P value	Adjusted OR (95%CI)^a	P value
Age (≥ 60 vs < 60)	0.67 (0.54-0.83)	< 0.001	1.10 (0.86-1.40)	0.468
Male vs female	1.58 (1.23-2.03)	< 0.001	0.76 (0.55-1.03)	0.079
High school or above vs middle school or below	1.29 (0.92-1.81)	0.137	0.95 (0.60-1.48)	0.839
Married vs other	1.04 (0.78-1.41)	0.780	0.84 (0.61-1.16)	0.281
Total household income (≥ 10000 vs < 10000, CNY)	0.89 (0.69-1.16)	0.390	0.87 (0.65-1.17)	0.352
Health insurance (yes vs no)	0.71 (0.46-1.12)	0.128	1.19 (0.66-2.30)	0.585
Current smoker vs others	0.79 (0.60-1.04)	0.089	1.29 (0.93-1.81)	0.129
Current alcohol drinker vs other	0.94 (0.71-1.24)	0.669	0.99 (0.69-1.41)	0.971
Active physical activity vs other	0.89 (0.72-1.10)	0.282	0.83 (0.65-1.06)	0.135
Disease status (yes vs no)
Hypertension	1.19 (0.94-1.50)	0.156	1.56 (1.21-2.02)	0.001
CVD	0.97 (0.71-1.32)	0.865	1.27 (0.93-1.74)	0.132
Dyslipidemia	0.96 (0.66-1.36)	0.810	1.72 (1.23-2.40)	0.001
Number of comorbidities (≥ 1 vs 0)	1.16 (0.94-1.44)	0.166	1.23 (0.96-1.58)	0.101
BMI (≥ 24 kg/m² vs < 24 kg/m²)	0.78 (0.61-0.98)	0.033	1.78 (1.36-2.32)	< 0.001
Self-reported general health (very good/good/fair vs poor/very poor)	0.95 (0.75-1.22)	0.693	0.89 (0.68-1.18)	0.414
High-sensitivity C-reactive protein (every 1-mg/L increase)	0.98 (0.95-1.00)	0.075	1.01 (0.99-1.02)	0.209

^aAll the factors listed in this table were adjusted for.

CNY: Chinese yuan; CVD: Cardiovascular disease; BMI: Body mass index; OR: Odds ratio.

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Table 3 Associations between prediabetes transitions and clinical outcomes during the 2015-2020 follow-up

Outcome/variables	n	N	Cumulative risk (95%CI)	Crude OR (95%CI)	P value	Adjusted OR (95%CI)^a	P value
CVD
Regression to normoglycemia	43	346	12.4 (9.0-15.9)	0.86 (0.60-1.23)	0.403	0.93 (0.64-1.36)	0.716
Persistent prediabetes	148	1041	14.2 (12.1-16.3)	1 (reference)		1 (reference)
Progression to diabetes	40	194	20.6 (14.9-26.3)	1.57 (1.06-2.31)	0.024	0.97 (0.62-1.52)	0.899
Kidney disease
Regression to normoglycemia	16	346	4.6 (2.4-6.8)	1.63 (0.88-3.03)	0.123	1.47 (0.78-2.78)	0.236
Persistent prediabetes	30	1038	2.9 (1.9-3.9)	1 (reference)		1 (reference)
Progression to diabetes	12	192	6.2 (2.8-9.7)	2.24 (1.13-4.46)	0.022	2.01 (0.90-4.48)	0.088
Mortality
Regression to normoglycemia	12	359	3.3 (1.5-5.2)	1.04 (0.54-2.03)	0.898	1.12 (0.56-2.23)	0.747
Persistent prediabetes	35	1092	3.2 (2.2-4.2)	1 (reference)		1 (reference)
Progression to diabetes	14	210	6.7 (3.3-10.0)	2.16 (1.14-4.08)	0.018	2.36 (1.18-4.72)	0.015

^aThe factors adjusted for included age, gender, marital status, education level, total household income, health insurance, physical activity, smoking status, drinking status, current health status, hypertension, dyslipidemia, comorbidity, body mass index, antihypertensive therapy, lipid-lowering therapy and glucose-lowering therapy.

OR: Odds ratio; CVD: Cardiovascular disease.

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Citation: Zhang JY, Xu YH, Wang ST, Huang Y, Zheng WX, Xiao Y, Yang ZY. Regression to normoglycemia, progression to diabetes, and their association with health outcomes in Chinese adults with untreated prediabetes. World J Diabetes 2026; 17(10): 124090
URL: https://www.wjgnet.com/1948-9358/full/v17/i10/124090.htm
DOI: https://dx.doi.org/10.4239/wjd.124090

Zhang JY, Xu YH, Wang ST, Huang Y, Zheng WX, Xiao Y, Yang ZY. Regression to normoglycemia, progression to diabetes, and their association with health outcomes in Chinese adults with untreated prediabetes. World J Diabetes 2026; 17(10): 124090 [DOI: 10.4239/wjd.124090]

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