Onishi Yukiko, Hayashi Tomoshige, Sato Kyoko K, Leonetti Donna L, Kahn Steven E, Fujimoto Wilfred Y, Boyko Edward J
Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, 2-2-6, Nihonbashi, Bakurocho, Chuo-ku, Tokyo 103-0002, Japan.
Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
J Diabetes Complications. 2020 Dec;34(12):107731. doi: 10.1016/j.jdiacomp.2020.107731. Epub 2020 Sep 6.
We compared 20 previously reported indices of insulin sensitivity derived from samples during an oral glucose tolerance test (OGTT) to determine which was best in predicting incident type 2 diabetes.
We prospectively followed 418 Japanese Americans without diabetes for 10-11 years. We compared ability to predict incident diabetes of 20 insulin sensitivity indices-9 based on fasting samples, 7 based on 2-h and/or fasting samples, and 4 based on multiple samples (0, 30, 60, 120 min) during an OGTT-by integrated discrimination improvement, category free net reclassification improvement, and area under the receiver operator characteristic curve.
There were 95 incident cases of diabetes. The Cederholm and Gutt indices, requiring more than only fasting samples, were the best to predict incident diabetes as judged by integrated discrimination improvement (0.187, 0.184), category free net reclassification improvement (0.962, 1.030), and area under the receiver operator characteristic curve (0.864, 0.863, respectively). Fasting indices were clearly inferior to both the Cederholm and Gutt indices.
Among the 20 indices, the Cederholm and Gutt indices predicted diabetes best but the Gutt index may be preferable because it requires fewer samples during an OGTT.
我们比较了20个先前报道的源自口服葡萄糖耐量试验（OGTT）期间样本的胰岛素敏感性指数，以确定哪个指数在预测2型糖尿病发病方面最佳。
我们对418名无糖尿病的日裔美国人进行了10至11年的前瞻性随访。我们通过综合鉴别改善、无类别净重新分类改善以及受试者工作特征曲线下面积，比较了20个胰岛素敏感性指数预测糖尿病发病的能力，其中9个基于空腹样本，7个基于2小时和/或空腹样本，4个基于OGTT期间的多个样本（0、30、60、120分钟）。
有95例糖尿病发病病例。通过综合鉴别改善（分别为0.187、0.184）、无类别净重新分类改善（分别为0.962、1.030）以及受试者工作特征曲线下面积（分别为0.864、0.863）判断，需要不止空腹样本的Cederholm指数和Gutt指数在预测糖尿病发病方面最佳。空腹指数明显不如Cederholm指数和Gutt指数。
在这20个指数中，Cederholm指数和Gutt指数预测糖尿病的能力最佳，但Gutt指数可能更可取，因为它在OGTT期间所需的样本较少。
