Reproducibility of Glycemic Measures Among Dysglycemic Youth and Adults in the RISE Study.

Autor:	Tjaden AH; The Biostatistics Center, Milken Institute School of Public Health The George Washington University, Rockville, MD, USA., Edelstein SL; The Biostatistics Center, Milken Institute School of Public Health The George Washington University, Rockville, MD, USA., Arslanian S; Division of Pediatric Endocrinology, Diabetes, and Metabolism, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA., Barengolts E; Department of Medicine, University of Illinois and Jesse Brown VA Medical Center, Chicago, IL, USA., Caprio S; Pediatric Endocrinology & Diabetes, Yale University School of Medicine, New Haven, CT, USA., Cree-Green M; Pediatric Endocrinology, University of Colorado Anschutz Medical Campus/Children's Hospital Colorado, Aurora, CO, USA., Lteif A; Division of Endocrinology and Metabolism, Indiana University School of Medicine and Roudebush VA Medical Center, Indianapolis, IN, USA., Mather KJ; Division of Endocrinology and Metabolism, Indiana University School of Medicine and Roudebush VA Medical Center, Indianapolis, IN, USA., Savoye M; Pediatric Endocrinology & Diabetes, Yale University School of Medicine, New Haven, CT, USA., Xiang AH; Department of Research & Evaluation, Kaiser Permanente Southern California, Los Angeles, CA, USA., Kahn SE; Division of Metabolism, Endocrinology and Nutrition, VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2023 Sep 18; Vol. 108 (10), pp. e1125-e1133.
DOI:	10.1210/clinem/dgad135
Abstrakt:	Aims: Previous work found poor reproducibility for measures of glycemia in individuals at risk for dysglycemia. Differences between youth and adults have not been assessed. Using youth and adults in the Restoring Insulin Secretion Study, we tested variability and classification concordance for hemoglobin A1C (HbA1c), fasting and 2-hour glucose from oral glucose tolerance tests (OGTTs). Methods: HbA1c and glucose on repeated samples obtained ∼6 weeks apart were compared in 66 youth (mean age 14.2 years) and 354 adults (52.7 years). Changes, coefficient of variation (CV), and concordance of diagnostic categories between the 2 visits were compared. Results: Mean difference between the 2 visits in HbA1c was higher in youth than adults (P < .001), while fasting glucose was similar and 2-hour glucose was lower in youth (P = .051). CV was smallest for HbA1c compared to fasting and 2-hour glucose. For HbA1c, youth had higher CV (P < .001); whereas CV for 2-hour glucose was lower for youth (P = .041). Classification concordance by HbA1c was lower in youth (P = .004). Using OGTT or HbA1c for classification, intervisit variability produced discordant classification in 20% of youth and 28% of adults. Using both fasting glucose and HbA1c, intervisit variability reduced discordant classification to 16% of adults while not improving classification in youth. Conclusions: Poor reproducibility and lack of classification concordance highlight the limitations of one-time testing, with important implications for assessing eligibility in clinical trials. Consideration should be given to using more than a single parameter for screening and diagnosis, especially when classification category is important. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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