Age, BMI, and Race Are Less Important Than Random Plasma Glucose in Identifying Risk of Glucose Intolerance
| Autor: | Lawrence S. Phillips, Mary K. Rhee, Jade M. Irving, Paul Kolm, Viola Vaccarino, David C. Ziemer, K.M. Venkat Narayan, Jane Caudle, William S. Weintraub, David D. Koch |
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| Rok vydání: | 2008 |
| Předmět: |
Advanced and Specialized Nursing
Glucose tolerance test medicine.medical_specialty medicine.diagnostic_test business.industry Endocrinology Diabetes and Metabolism Odds ratio medicine.disease Impaired glucose tolerance Endocrinology Diabetes mellitus Internal medicine Internal Medicine Medicine Risk factor Family history business Body mass index Mass screening |
| Zdroj: | Diabetes Care. 31:884-886 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc07-2282 |
| Popis: | OBJECTIVE—Age, BMI, and race/ethnicity are used in National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and American Diabetes Association (ADA) guidelines to prompt screening for pre-diabetes and diabetes, but cutoffs have not been evaluated rigorously. RESEARCH DESIGN AND METHODS—Random plasma glucose (RPG) was measured and 75-g oral glucose tolerance tests were performed in 1,139 individuals without known diabetes. Screening performance was assessed by logistic regression and area under the receiver operating characteristic curve (AROC). RESULTS—NIDDK/ADA indicators age >45 years and BMI >25 kg/m2 provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race and better still with models of age, BMI, race, sex, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG >125 mg/dl could be used to prompt further evaluation with an OGTT. CONCLUSIONS—Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and pre-diabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility. |
| Databáze: | OpenAIRE |
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