Modelling of OGTT curve identifies 1 h plasma glucose level as a strong predictor of incident type 2 diabetes: results from two prospective cohorts

Summary, in English

Aims/hypothesis The relevance of the OGTT in predicting type 2 diabetes is unclear. We assessed the performance of 14 OGTT glucose traits in type 2 diabetes prediction. Methods We studied 2,603 and 2,386 Europeans from the Botnia study and Malmo Prevention Project (MPP) cohorts with baseline OGTT data. Over a follow-up period of 4.94 years and 23.5 years, 155 (5.95%) and 467 (19.57%) participants, respectively, developed type 2 diabetes. The main outcome was incident type 2 diabetes. Results One-hour plasma glucose (1h-PG) was a fair/good predictor of incident type 2 diabetes in the Botnia study and MPP (AUC for receiver operating characteristic [AUC(ROC)] 0.80 [0.77, 0.84] and 0.70 [0.68, 0.73]). 1h-PG alone outperformed the prediction model of multiple clinical risk factors (age, sex, BMI, family history of type 2 diabetes) in the Botnia study and MPP (AUC(ROC) 0.75 [0.72, 0.79] and 0.67 [0.64, 0.70]). The same clinical risk factors added to 1h-PG modestly increased prediction for incident type 2 diabetes (Botnia, AUC(ROC) 0.83 [0.80, 0.86]; MPP, AUC(ROC) 0.74 [0.72, 0.77]). 1h-PG also outperformed HbA(1c) in predicting type 2 diabetes in the Botnia cohort. A 1h-PG value of 8.9 mmol/l and 8.4 mmol/l was the optimal cut-point for initial screening and selection of high-risk individuals in the Botnia study and MPP, respectively, and represented 30% and 37% of all participants in these cohorts. High-risk individuals had a substantially increased risk of incident type 2 diabetes (OR 8.0 [5.5, 11.6] and 3.8 [3.1, 4.7]) and captured 75% and 62% of all incident type 2 diabetes in the Botnia study and MPP. Conclusions/interpretation1h-PG is a valuable prediction tool for identifying adults at risk for future type 2 diabetes.

• Författare: Akram Alyass; Peter Almgren; Mikael Åkerlund; Jonathan Dushoff; Bo Isomaa; Peter Nilsson; Tiinamaija Tuomi; Valeriya Lyssenko; Leif Groop; David Meyre
• Avdelning/ar: Translationell Muskel Forskning; Internmedicin - epidemiologi; EXODIAB: Excellence of Diabetes Research in Sweden; EpiHealth: Epidemiology for Health
• Publiceringsår: 2015
• Språk: Engelska
• Sidor: 87-97
• Publikation/Tidskrift/Serie: Diabetologia
• Volym: 58
• Issue: 1
• Länkar: http://dx.doi.org/10.1007/s00125-014-3390-x
• Dokumenttyp: Artikel i tidskrift
• Förlag: Springer
• Ämne: Endocrinology and Diabetes
• Nyckelord: Incident type 2 diabetes; Mathematical modelling; One-hour post-OGTT; plasma glucose; Oral glucose tolerance test; Prevention
• Status: Published
• Forskningsgrupp: Genomics, Diabetes and Endocrinology; Internal Medicine - Epidemiology
• ISBN/ISSN/Övrigt: ISSN: 1432-0428