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

Mette Lundgren Nielsen, Manan Pareek, Margrét Leósdóttir, Kurt Højlund, Karl Fredrik Eriksson, Peter M. Nilsson, Michael Hecht Olsen

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstrakt

    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: A prospective, population-based cohort study (Malmo Preventive Project) with inclusion of subjects from 1974 to 1992. Methods: A total of 5256 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. The 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 post-load 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 a 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.

    OriginalsprogEngelsk
    Sider (fra-til)591-600
    Antal sider10
    TidsskriftEuropean Journal of Endocrinology
    Vol/bind174
    Udgave nummer5
    DOI
    StatusUdgivet - 1 maj 2016

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