Elevated HbA1c and fasting plasma glucose in predicting diabetes incidence among older adults: are two better than one?
Elevated HbA1c and fasting plasma glucose in predicting diabetes incidence among older adults: are two better than one?
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DOI：
10.2337/dc12-2631
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发表时间：
2013-12
期刊：
影响因子：
16.2
通讯作者：
Health ABC Study
中科院分区：
文献类型：
--
作者：
Lipska KJ;Inzucchi SE;Van Ness PH;Gill TM;Kanaya A;Strotmeyer ES;Koster A;Johnson KC;Goodpaster BH;Harris T;De Rekeneire N;Health ABC Study
为了确定哪些指标-空腹血糖受损(IFG)、糖化血红蛋白(HbA1c)升高或两者兼而有之-最好地预测老年人的糖尿病发病。从健康、衰老和身体成分研究中，我们选择了没有糖尿病的人，并根据美国糖尿病协会的指南定义了空腹血糖(100-125 mg/dL)和升高的HbA1c(5.7-6.4%)。糖尿病事件是基于自我报告，在7年的随访中使用降血糖药物或HbA1c≥6.5%。Logistic回归分析根据年龄、性别、种族、地点、BMI、吸烟、血压和体力活动进行了调整。对有IFG和IFG和HbA1c升高的模型进行了辨别和校准评估。在1690名成年人(平均年龄76.5岁，46%为男性，32%为黑人)中，183人(10.8%)在7年内发展为糖尿病。糖化血红蛋白增高者患糖尿病的调整优势比为6.2(95%可信区间4.4-8.8)，糖化血红蛋白增高者为11.3(7.8-16.4)，糖化血红蛋白增高者为5.7%。当同时考虑空腹血糖和糖化血红蛋白时，空腹血糖和糖化血红蛋白增高者的优势比分别为3.5(1.9-6.3)、8.0(4.8-13.2)和26.2(16.3-42.1)(与空腹血糖和糖化血红蛋白正常者相比)。将升高的HbA1c添加到带有IFG的模型中，导致了更好的分辨率和校准。同时患有IFG和HbA1c升高的老年人在7年内患糖尿病的几率显著增加。联合筛查空腹血糖和糖化血红蛋白可以确定老年人有非常高的糖尿病风险。
To determine which measures—impaired fasting glucose (IFG), elevated HbA1c, or both—best predict incident diabetes in older adults. From the Health, Aging, and Body Composition study, we selected individuals without diabetes, and we defined IFG (100–125 mg/dL) and elevated HbA1c (5.7–6.4%) per American Diabetes Association guidelines. Incident diabetes was based on self-report, use of antihyperglycemic medicines, or HbA1c ≥6.5% during 7 years of follow-up. Logistic regression analyses were adjusted for age, sex, race, site, BMI, smoking, blood pressure, and physical activity. Discrimination and calibration were assessed for models with IFG and with both IFG and elevated HbA1c. Among 1,690 adults (mean age 76.5, 46% men, 32% black), 183 (10.8%) developed diabetes over 7 years. Adjusted odds ratios of diabetes were 6.2 (95% CI 4.4–8.8) in those with IFG (versus those with fasting plasma glucose [FPG] <100 mg/dL) and 11.3 (7.8–16.4) in those with elevated HbA1c (versus those with HbA1c <5.7%). When FPG and HbA1c were considered together, odds ratios were 3.5 (1.9–6.3) in those with IFG only, 8.0 (4.8–13.2) in those with elevated HbA1c only, and 26.2 (16.3–42.1) in those with both IFG and elevated HbA1c (versus those with normal FPG and HbA1c). Addition of elevated HbA1c to the model with IFG resulted in improved discrimination and calibration. Older adults with both IFG and elevated HbA1c have a substantially increased odds of developing diabetes over 7 years. Combined screening with FPG and HbA1c may identify older adults at very high risk for diabetes.
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影响因子：
16.2
作者：
Bonora E;Kiechl S;Mayr A;Zoppini G;Targher G;Bonadonna RC;Willeit J
通讯作者：
Willeit J
影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
预测糖尿病：临床，生物学和遗传方法：来自胰岛素抵抗综合征（DESIR）的流行病学研究的数据。
影响因子：
16.2
作者：
Balkau, Beverley;Lange, Celine;Fezeu, Leopold;Tichet, Jean;De Lauzon-Guillain, Blandine;Cernichow, Sebastien;Fumeron, Frederic;Froguel, Philippe;Vaxillaire, Martine;Cauchi, Stephane;Ducimetiere, Pierre;Eschwege, Eveline
通讯作者：
Eschwege, Eveline
影响因子：
5
作者：
Pepe, MS;Janes, H;Newcomb, P
通讯作者：
Newcomb, P
影响因子：
16.2
作者：
Kanaya, AM;Fyr, CLW;Barrett-Connor, E
通讯作者：
Barrett-Connor, E