Enhanced predictive capability of a 1-hour oral glucose tolerance test : A prospective population-based cohort study
(2018) In Diabetes Care 41(1). p.171-177- Abstract
OBJECTIVE To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS We conducted a prospective population-based cohort study of 4,867men, randomly selected fromprespecified birth cohorts between 1921 and 1949,who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h (≥8.6 mmol/L) versus 2-h (≥7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, andmortality were compared using Kaplan-Meier analysis, Cox... (More)
OBJECTIVE To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS We conducted a prospective population-based cohort study of 4,867men, randomly selected fromprespecified birth cohorts between 1921 and 1949,who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h (≥8.6 mmol/L) versus 2-h (≥7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, andmortality were compared using Kaplan-Meier analysis, Cox proportional hazards regression, and net reclassification improvement. RESULTS Median agewas 48 years (interquartile range [IQR] 48-49). During follow-up (median 33 years [IQR 24-37]), 636 (13%) developed type 2 diabetes. Elevated 1-h glucose was associatedwith incident diabetes (hazard ratio 3.40 [95% CI 2.90-3.98], P < 0.001) and provided better risk assessment than impaired glucose tolerance (Harrell concordance index 0.637 vs. 0.511, P < 0.001). Addition of a 1-hmeasurement in subjects stratified by fasting glucose provided greater net reclassification improvement than the addition of a 2-h measurement (0.214 vs. 0.016, respectively). Finally, the 1-h glucose was significantly associated with vascular complications and mortality. CONCLUSIONS The 1-h blood glucose level is a stronger predictor of future type 2 diabetes than the 2-h level and is associated with diabetes complications and mortality.
(Less)
- author
- Pareek, Manan ; Bhatt, Deepak L. ; Nielsen, Mette L. ; Jagannathan, Ram ; Eriksson, Karl Fredrik LU ; Nilsson, Peter M. LU ; Bergman, Michael and Olsen, Michael H.
- organization
- publishing date
- 2018
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Diabetes Care
- volume
- 41
- issue
- 1
- pages
- 7 pages
- publisher
- American Diabetes Association
- external identifiers
-
- pmid:29138275
- scopus:85038961961
- ISSN
- 0149-5992
- DOI
- 10.2337/dc17-1351
- language
- English
- LU publication?
- yes
- id
- c425b721-e539-4e88-8475-dd9c4af51632
- date added to LUP
- 2018-01-22 10:43:29
- date last changed
- 2024-07-08 08:00:28
@article{c425b721-e539-4e88-8475-dd9c4af51632, abstract = {{<p>OBJECTIVE To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS We conducted a prospective population-based cohort study of 4,867men, randomly selected fromprespecified birth cohorts between 1921 and 1949,who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h (≥8.6 mmol/L) versus 2-h (≥7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, andmortality were compared using Kaplan-Meier analysis, Cox proportional hazards regression, and net reclassification improvement. RESULTS Median agewas 48 years (interquartile range [IQR] 48-49). During follow-up (median 33 years [IQR 24-37]), 636 (13%) developed type 2 diabetes. Elevated 1-h glucose was associatedwith incident diabetes (hazard ratio 3.40 [95% CI 2.90-3.98], P < 0.001) and provided better risk assessment than impaired glucose tolerance (Harrell concordance index 0.637 vs. 0.511, P < 0.001). Addition of a 1-hmeasurement in subjects stratified by fasting glucose provided greater net reclassification improvement than the addition of a 2-h measurement (0.214 vs. 0.016, respectively). Finally, the 1-h glucose was significantly associated with vascular complications and mortality. CONCLUSIONS The 1-h blood glucose level is a stronger predictor of future type 2 diabetes than the 2-h level and is associated with diabetes complications and mortality.</p>}}, author = {{Pareek, Manan and Bhatt, Deepak L. and Nielsen, Mette L. and Jagannathan, Ram and Eriksson, Karl Fredrik and Nilsson, Peter M. and Bergman, Michael and Olsen, Michael H.}}, issn = {{0149-5992}}, language = {{eng}}, number = {{1}}, pages = {{171--177}}, publisher = {{American Diabetes Association}}, series = {{Diabetes Care}}, title = {{Enhanced predictive capability of a 1-hour oral glucose tolerance test : A prospective population-based cohort study}}, url = {{http://dx.doi.org/10.2337/dc17-1351}}, doi = {{10.2337/dc17-1351}}, volume = {{41}}, year = {{2018}}, }