Enhanced predictive capability of a 1-hour oral glucose tolerance test : A prospective population-based cohort study

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Pareek, MananOdense University Hospital,Brigham and Women's Hospital / Harvard Medical School (author)

Enhanced predictive capability of a 1-hour oral glucose tolerance test : A prospective population-based cohort study

Article/chapterEnglish2018

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2017-11-14
American Diabetes Association,2018
7 s.

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LIBRIS-ID:oai:lup.lub.lu.se:c425b721-e539-4e88-8475-dd9c4af51632
https://lup.lub.lu.se/record/c425b721-e539-4e88-8475-dd9c4af51632URI
https://doi.org/10.2337/dc17-1351DOI

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Summary in:English

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OBJECTIVE To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS We conducted a prospective population-based cohort study of 4,867men, randomly selected fromprespecified birth cohorts between 1921 and 1949,who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h (≥8.6 mmol/L) versus 2-h (≥7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, andmortality were compared using Kaplan-Meier analysis, Cox proportional hazards regression, and net reclassification improvement. RESULTS Median agewas 48 years (interquartile range [IQR] 48-49). During follow-up (median 33 years [IQR 24-37]), 636 (13%) developed type 2 diabetes. Elevated 1-h glucose was associatedwith incident diabetes (hazard ratio 3.40 [95% CI 2.90-3.98], P < 0.001) and provided better risk assessment than impaired glucose tolerance (Harrell concordance index 0.637 vs. 0.511, P < 0.001). Addition of a 1-hmeasurement in subjects stratified by fasting glucose provided greater net reclassification improvement than the addition of a 2-h measurement (0.214 vs. 0.016, respectively). Finally, the 1-h glucose was significantly associated with vascular complications and mortality. CONCLUSIONS The 1-h blood glucose level is a stronger predictor of future type 2 diabetes than the 2-h level and is associated with diabetes complications and mortality.

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Bhatt, Deepak L.Brigham and Women's Hospital / Harvard Medical School (author)
Nielsen, Mette L.Odense University Hospital (author)
Jagannathan, RamNew York University (author)
Eriksson, Karl FredrikLund University,Lunds universitet,Translationell muskelforskning,Forskargrupper vid Lunds universitet,Translational Muscle Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-ker (author)
Nilsson, Peter M.Lund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-pni (author)
Bergman, MichaelNew York University (author)
Olsen, Michael H.Odense University Hospital (author)
Odense University HospitalBrigham and Women's Hospital / Harvard Medical School (creator_code:org_t)

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In:Diabetes Care: American Diabetes Association41:1, s. 171-1770149-59921935-5548

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Endocrinology an ...

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