Fasting Plasma Glucose Levels Within the Normoglycemic Range in Childhood as a Predictor of Prediabetes and Type 2 Diabetes in Adulthood The Bogalusa Heart Study
Fasting Plasma Glucose Levels Within the Normoglycemic Range in Childhood as a Predictor of Prediabetes and Type 2 Diabetes in Adulthood The Bogalusa Heart Study
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DOI：
10.1001/archpediatrics.2009.268
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发表时间：
2010-02-01
影响因子：
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通讯作者：
Berenson, Gerald S.
中科院分区：
文献类型：
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作者：
Nguyen, Quoc Manh;Srinivasan, Sathanur R.;Berenson, Gerald S.
目的：确定儿童时期空腹血糖(FPG)水平在正常血糖范围内升高是否预测成年后的糖尿病。设计：回顾性队列研究。背景：路易斯安那州博加卢萨社区。参与者：正常血糖(n=1723)，糖尿病前期(n=79)，和年龄在19到44岁的成人2型糖尿病患者(n=47)，从儿童时期开始连续跟踪调查了平均21年。主要暴露：在成人的最后一次调查中，基线儿童空腹血糖水平升高与糖尿病前期或糖尿病状态的关系。主要观察指标：受试者操作特征分析和纵向Logistic回归优势比。结果：成人糖尿病患病率按基线儿童空腹血糖水平的四分位数显示糖尿病前期的下降趋势(P<；.001)和糖尿病(P=.03)，表观阈值出现在第50个百分位数(86 mg/dL)或以上。对于上述阈值的预测值，受试者操作曲线下面积分析得出糖尿病前期的C值为0.855，糖尿病模型的C值为0.789，其敏感性和特异性分别为76.9%和85.2%，糖尿病为75.0%和76.0%。在包括从儿童到成年的人体测量、血流动力学和代谢变量以及基线儿童空腹血糖状态(>；=vs)的多变量分析中
Objectives: To determine whether childhood elevated fasting plasma glucose (FPG) levels within the normoglycemic range predict diabetes in adulthood.Design: Retrospective cohort study.Setting: Community of Bogalusa, Louisiana.Participants: Normoglycemic (n = 1723), prediabetic (n = 79), and type 2 diabetic (n = 47) adults aged 19 to 44 years followed up serially for an average of 21 years since childhood.Main Exposures: Association of elevated baseline childhood FPG levels with the prediabetic or diabetic status at the last survey in adulthood.Main Outcome Measures: Receiver operating characteristic analysis and longitudinal logistic regression odds ratios.Results: The prevalent rate of adult diabetes status by quartiles of baseline childhood FPG levels showed an ad-verse trend for prediabetes (P < .001) and diabetes (P =. 03), with an apparent threshold occurring at or above the 50th percentile (86 mg/dL). Regarding the predictive value of the above threshold, the area under the receiver operating curve analysis yielded a C value of 0.855 for prediabetes and 0.789 for diabetes models, with sensitivity and specificity, respectively, of 76.9% and 85.2% for prediabetes and 75.0% and 76.0% for diabetes. In a multivariate analysis that included anthropometric, hemodynamic, and metabolic variables from childhood to adulthood and baseline childhood FPG status (>= vs