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Karl-Fredrik Eriksson

Associate professor

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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.

Author

  • Mette Lundgren Nielsen
  • Manan Pareek
  • Margrét Leosdottir
  • Kurt Højlund
  • Karl-Fredrik Eriksson
  • Peter Nilsson
  • Michael Hecht Olsen

Summary, in English

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.

Department/s

  • Internal Medicine - Epidemiology
  • Vascular Diseases - Clinical Research
  • EpiHealth: Epidemiology for Health

Publishing year

2016-02-12

Language

English

Pages

591-600

Publication/Series

European Journal of Endocrinology

Volume

174

Issue

5

Document type

Journal article

Publisher

Society of the European Journal of Endocrinology

Topic

  • Endocrinology and Diabetes

Status

Published

Research group

  • Internal Medicine - Epidemiology
  • Vascular Diseases - Clinical Research

ISBN/ISSN/Other

  • ISSN: 1479-683X