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Follow-up duration influences the relative importance of OGTT and optimal timing of glucose measurements for predicting future type 2 diabetes.

Nielsen, Mette Lundgren; Pareek, Manan; Leosdottir, Margrét LU ; Højlund, Kurt; Eriksson, Karl-Fredrik LU ; Nilsson, Peter LU and Olsen, Michael Hecht (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:
author
organization
publishing date
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
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
2016-03-03 14:20:18
date last changed
2017-10-22 03:20:22
@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},
  volume       = {174},
  year         = {2016},
}