Fasting plasma glucose cutoff for diagnosis of diabetes in a Japanese population
Fasting plasma glucose cutoff for diagnosis of diabetes in a Japanese population
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DOI：
10.1210/jc.2007-2819
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发表时间：
2008-09-01
影响因子：
5.8
通讯作者：
Kiyohara, Yutaka
中科院分区：
文献类型：
--
作者：
Doi, Yasufumi;Kubo, Michiaki;Kiyohara, Yutaka
目的：我们在日本普通人群中研究了空腹血糖（FPG）和2小时负荷后血糖（PG）水平之间的关系，以及对应于2小时PG为11.1 mmol/L（黄金标准诊断标准）的最佳FPG截止水平。设计：对1988年和2002年的2421例受试者和2698例受试者进行了横断面研究，年龄在40-79岁之间，未使用抗糖尿病药物，并进行了口服葡萄糖耐量试验。FPG和2-h PG之间的关系进行了研究，通过各种回归模型和受试者工作特征曲线。结果：FPG和2-h PG之间的关系的最佳拟合模型是二次回归模型。根据该模型，对应于2小时PG 11.1 mmol/L的FPG截止水平在1988年为6.2 mmol/L，在2002年为6.3 mmol/L。在合并人群中，FPG临界点为6.3 mmol/L;检测2 h PG 11.1 mmol/L的敏感性和特异性分别为75.2%和88.6%。受试者工作特征曲线分析证实，1988年和2002年人群中相应的FPG点均为6.2 mmol/L。在分层分析中，FPG临界值随着体重指数水平的增加而增加;然而，即使在体重指数大于或等于30 kg/m2的受试者中，FPG临界值也低于7.0 mmol/L。我们的研究结果表明，对应于2小时PG为11.1 mmol/L的FPG截止水平，一般日本人群中的血肌酐水平低于目前的诊断标准。
Objective: We examined the relationship between fasting plasma glucose (FPG) and 2-h post-load glucose (PG) levels, and the optimal FPG cutoff level to correspond to a 2-h PG of 11.1 mmol/liter, the gold standard diagnostic criterion, in a general Japanese population.Design: Cross-sectional study populations of 2421 subjects in 1988 and 2698 subjects in 2002, aged 40-79 yr and without antidiabetic medication, were tested with an oral glucose tolerance test. The relationship between FPG and 2-h PG was investigated by various regression models and a receiver operating characteristic curve.Results: The best-fit model for the relationship between FPG and 2-h PG was a quadratic regression model. The FPG cutoff levels corresponding to the 2-h PG of 11.1 mmol/liter by this model were 6.2 mmol/liter in 1988 and 6.3 mmol/liter in 2002. In the combined populations, the FPG cutoff point was 6.3 mmol/liter; the sensitivity and specificity of this cutoff point for detecting a 2-h PG of 11.1 mmol/liter were 75.2 and 88.6%, respectively. The receiver operating characteristic curve analysis confirmed that the corresponding FPG point was 6.2 mmol/liter in both the 1988 and 2002 populations. In a stratified analysis, the FPG cutoff level increased with increasing body mass index levels; however, even in subjects with body mass index more than or equal to 30 kg/m(2), the FPG cutoff level was lower than 7.0 mmol/liter.Conclusions: Our findings suggest that the FPG cutoff level corresponding to the 2-h PG of 11.1 mmol/liter in the general Japanese population is lower than the current diagnostic criterion.