Risk for diabetes mellitus in middle-aged Caucasian male participants of the PROCAM study: Implications for the definition of impaired fasting glucose by the American Diabetes Association
Risk for diabetes mellitus in middle-aged Caucasian male participants of the PROCAM study: Implications for the definition of impaired fasting glucose by the American Diabetes Association
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DOI：
10.1210/jc.85.9.3101
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发表时间：
2000-09-01
影响因子：
5.8
通讯作者：
Assmann, G
中科院分区：
文献类型：
--
作者：
von Eckardstein, A;Schulte, H;Assmann, G
美国糖尿病协会和世界卫生组织对糖尿病的诊断标准存在争议。在一项前瞻性人群研究中，我们评估了 3737 名男性的数据，年龄为 36-60 岁，无糖尿病且在进入研究时空腹血糖水平低于 7 mmol/L，他们在 4-10 年的随访期间至少进行了 1 次重复检查。在平均 6.3 年的随访期间，200 名男性患上了糖尿病。他们在体重指数、空腹血清葡萄糖水平、高密度脂蛋白胆固醇和糖尿病家族史方面与 3537 名男性存在显着差异。受试者工作曲线分析显示，5.72 mmoI/L 的葡萄糖水平是最佳区分临界值。通过多重逻辑函数 (MLF) 分析进行全球风险评估后，所有糖尿病发病率的 69.6% 发生在 MLF 算法定义的最高五分位数。与其余人群相比，这五分之一男性的相对风险为 8.7。根据接受者算子特征曲线下面积估计的 MLF 风险评估性能与空腹血糖水平相似。通过多种危险因素进行的整体风险评估并不能改善中年男性空腹血糖对糖尿病的预测。 5.72 mmol/L 葡萄糖的较低区分临界值可能有助于减少先前报道的糖尿病前期状态诊断中空腹血糖受损（美国糖尿病协会）和糖耐量受损（世界卫生组织）之间的不一致。
The criteria of the American Diabetes Association and the WHO for the diagnosis of diabetes mellitus are controversially discussed. In a prospective population study, we evaluated the data of 3737 men, aged 36-60 yr, without diabetes mellitus and with fasting serum glucose levels less than 7 mmol/L at entry into the study who had at least 1 repeat examination during a follow-up of 4-10 yr. During a mean follow-up of 6.3 yr, 200 men developed diabetes mellitus. They differed significantly from 3537 men by body mass index, fasting serum levels of glucose, high density lipoprotein cholesterol, and family history positive for diabetes mellitus. Receiver operating curve analysis revealed that a glucose level of 5.72 mmoI/L was the best discriminatory cut-off. Upon global risk estimation by multiple logistic function (MLF) analysis, 69.6% of all diabetes mellitus incidences occurred in the highest quintile as defined by the MLF algorithm. The relative risk of a men in this quintile was 8.7 compared to that in the residual population. The performance of risk assessment by MLF as estimated by the area under the receiver operator characteristic curve was similar to fasting glucose levels.Global risk estimation by multiple risk factors does not improve the prediction of diabetes mellitus by fasting glucose in middle-aged men. The lower discriminatory cut-off of 5.72 mmol/L glucose may help to reduce the previously reported discordance between impaired fasting glucose (American Diabetes Association) and impaired glucose tolerance (WHO) in diagnosis of the prediabetic state.