Reproducibility of a prediabetes classification in a contemporary population.
Reproducibility of a prediabetes classification in a contemporary population.
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DOI：
10.1016/j.metop.2020.100031
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发表时间：
2020-06-01
期刊：
影响因子：
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通讯作者：
Brodsky, Irwin
中科院分区：
文献类型：
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作者：
Chadha, Chhavi;Pittas, Anastassios G;Brodsky, Irwin
目标：为了评估是否符合空腹血糖（FPG）和HbA 1c标准的糖尿病前期的高危人群表明，几乎肯定存在的dysplasia的重复testing.METHODS：观察性研究使用的数据从维生素D和2型糖尿病（D2 D）的研究。在筛选访视1时测量HbA 1c、FPG;在筛选访视2时测量FPG、HbA 1c和2小时血糖（2 hPG）（中位数为21天后）;受试者被分类为血糖调节正常（所有3项检查均在正常范围内）、前驱糖尿病或糖尿病（3项检查中至少有1项在糖尿病范围内）。根据筛查访视1时的FPG和HbA 1c值，开发了一个预测模型，以估计在筛查访视2时确诊糖尿病和检测糖尿病的概率。在筛选访视1时符合FPG和HbA 1c前驱糖尿病标准的1271名参与者中，98.6%的患者在重复检测时表现出精神障碍（定义为前驱糖尿病或糖尿病）（84.5%被归类为前驱糖尿病，14.1%被重新归类为糖尿病）。那些糖尿病患者中，62.6%被确定为2 hPG单独。结论：FPG和HbA 1c的联合测量是一个可靠的和可重复的措施，以确定存在的人在高风险的糖尿病。提供了一个预测模型，以帮助临床医生决定口服葡萄糖耐量试验是否会提供基于2 hPG标准检测糖尿病的价值。
AIMS: To assess whether meeting both fasting plasma glucose (FPG) and HbA1c criteria for prediabetes in people at high risk indicates with near certainty the presence of dysglycemia on repeat testing.METHODS: Observational study using data from Vitamin D and Type 2 Diabetes (D2d) study. HbA1c, FPG were measured at screening visit 1; FPG, HbA1c and 2 h plasma glucose (2hPG) measured at screening visit 2 (a median of 21 days later); participants classified as having normal glucose regulation (all 3 tests in normal range), prediabetes or diabetes (at least 1 of 3 tests in diabetes range). A predictive model was developed to estimate the probability of confirming dysglycemia and for detecting diabetes at screening visit 2 based on values of FPG and HbA1c at screening visit 1.RESULTS: Of 1271 participants who met both FPG and HbA1c criteria for prediabetes at screening visit 1, 98.6% exhibited dysglycemia (defined as prediabetes or diabetes) on repeat testing (84.5% were classified as having prediabetes, 14.1% were reclassified as having diabetes). Of those with diabetes, 62.6% were identified by 2hPG alone.CONCLUSIONS: Combined measurement of FPG and HbA1c is a reliable and reproducible measure to identify presence of dysglycemia among people at high risk. A prediction model is provided to help clinicians decide whether an oral glucose tolerance test will provide value in detecting diabetes based on the 2hPG criterion.