Follow-up duration influences the relative importance of OGTT and optimal timing of glucose measurements for predicting future type 2 diabetes.
(2016) In European Journal of Endocrinology 174(5). p.591-600- Abstract
- OBJECTIVE:
To examine the impact of follow-up duration on the incremental prognostic yield of a baseline oral glucose tolerance test (OGTT) for predicting type 2 diabetes and to assess the discrimination ability of blood glucose (BG) obtained at different time points during OGTT.
DESIGN:
Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974-1992.
METHODS:
5,256 men without diabetes, who had BG measured at 0, 20, 40, 60, 90, and 120 min during OGTT (30 g/m2 glucose), were followed for 30 years. Incident type 2 diabetes was recorded using registries. Performance of OGTT added to a clinical prediction model (age, body mass... (More) - OBJECTIVE:
To examine the impact of follow-up duration on the incremental prognostic yield of a baseline oral glucose tolerance test (OGTT) for predicting type 2 diabetes and to assess the discrimination ability of blood glucose (BG) obtained at different time points during OGTT.
DESIGN:
Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974-1992.
METHODS:
5,256 men without diabetes, who had BG measured at 0, 20, 40, 60, 90, and 120 min during OGTT (30 g/m2 glucose), were followed for 30 years. Incident type 2 diabetes was recorded using registries. Performance of OGTT added to a clinical prediction model (age, body mass index (BMI), diastolic blood pressure, fasting BG, triglycerides, and family history of diabetes) was assessed using Harrell's concordance index (C-index) and integrated discrimination improvement (IDI).
RESULTS:
Median age was 48 years, mean BMI 24.9 kg/m2, and mean fasting BG 4.7 mmol/L. Models with added postload BG performed better than the clinical model (C-index: p=0.08 for BG at 120 min at 5 years, otherwise p≤0.045; IDI: p≥0.06 for BG at 60 and 90 min at 5 years, otherwise p≤0.01). With longer follow-up duration, C-index decreased, and the C-index increase associated with OGTT was attenuated. Models including BG at 60 or 90 min performed significantly better than the model with BG at 120 min, evident beyond follow-up of 10 and 5 years, respectively.
CONCLUSIONS:
OGTT provided incremental prognostic yield for type 2 diabetes prediction. BG measured at 60 or 90 min provided better discrimination than BG at 120 min. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/8825601
- author
- Nielsen, Mette Lundgren ; Pareek, Manan ; Leosdottir, Margrét LU ; Højlund, Kurt ; Eriksson, Karl-Fredrik LU ; Nilsson, Peter LU and Olsen, Michael Hecht
- organization
- publishing date
- 2016-02-12
- type
- Contribution to journal
- publication status
- published
- subject
- in
- European Journal of Endocrinology
- volume
- 174
- issue
- 5
- pages
- 591 - 600
- publisher
- Society of the European Journal of Endocrinology
- external identifiers
-
- pmid:26873227
- scopus:84969988660
- wos:000375653400009
- pmid:26873227
- ISSN
- 1479-683X
- DOI
- 10.1530/EJE-15-1221
- language
- English
- LU publication?
- yes
- id
- b01cd865-a9be-42c2-95da-e57aafa43927 (old id 8825601)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/26873227?dopt=Abstract
- date added to LUP
- 2016-04-01 10:40:46
- date last changed
- 2022-04-04 20:16:47
@article{b01cd865-a9be-42c2-95da-e57aafa43927,
abstract = {{OBJECTIVE:<br/><br>
<br/><br>
To examine the impact of follow-up duration on the incremental prognostic yield of a baseline oral glucose tolerance test (OGTT) for predicting type 2 diabetes and to assess the discrimination ability of blood glucose (BG) obtained at different time points during OGTT.<br/><br>
DESIGN:<br/><br>
<br/><br>
Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974-1992.<br/><br>
METHODS:<br/><br>
<br/><br>
5,256 men without diabetes, who had BG measured at 0, 20, 40, 60, 90, and 120 min during OGTT (30 g/m2 glucose), were followed for 30 years. Incident type 2 diabetes was recorded using registries. Performance of OGTT added to a clinical prediction model (age, body mass index (BMI), diastolic blood pressure, fasting BG, triglycerides, and family history of diabetes) was assessed using Harrell's concordance index (C-index) and integrated discrimination improvement (IDI).<br/><br>
RESULTS:<br/><br>
<br/><br>
Median age was 48 years, mean BMI 24.9 kg/m2, and mean fasting BG 4.7 mmol/L. Models with added postload BG performed better than the clinical model (C-index: p=0.08 for BG at 120 min at 5 years, otherwise p≤0.045; IDI: p≥0.06 for BG at 60 and 90 min at 5 years, otherwise p≤0.01). With longer follow-up duration, C-index decreased, and the C-index increase associated with OGTT was attenuated. Models including BG at 60 or 90 min performed significantly better than the model with BG at 120 min, evident beyond follow-up of 10 and 5 years, respectively.<br/><br>
CONCLUSIONS:<br/><br>
<br/><br>
OGTT provided incremental prognostic yield for type 2 diabetes prediction. BG measured at 60 or 90 min provided better discrimination than BG at 120 min.}},
author = {{Nielsen, Mette Lundgren and Pareek, Manan and Leosdottir, Margrét and Højlund, Kurt and Eriksson, Karl-Fredrik and Nilsson, Peter and Olsen, Michael Hecht}},
issn = {{1479-683X}},
language = {{eng}},
month = {{02}},
number = {{5}},
pages = {{591--600}},
publisher = {{Society of the European Journal of Endocrinology}},
series = {{European Journal of Endocrinology}},
title = {{Follow-up duration influences the relative importance of OGTT and optimal timing of glucose measurements for predicting future type 2 diabetes.}},
url = {{http://dx.doi.org/10.1530/EJE-15-1221}},
doi = {{10.1530/EJE-15-1221}},
volume = {{174}},
year = {{2016}},
}