Rong Lingjun, Luo Na, Gong Yanping, Tian Hui, Sun Banruo, Li Chunlin
Department of Endocrinology, the Second Medical Center, the People's Liberation Army General Hospital, Beijing, China.
Department of Endocrinology, the Second Medical Center, the People's Liberation Army General Hospital, Beijing, China; National Clinical Research Center for Geriatric Disease, the People's Liberation Army General Hospital, Beijing, China.
Diabetes Res Clin Pract. 2021 Mar;173:108683. doi: 10.1016/j.diabres.2021.108683. Epub 2021 Feb 17.
There have been few reports regarding the association between 1 h-PG concentration and type 2 diabetes mellitus (T2DM) in the elderly. This study was performed to assess the efficacy of 1 h-PG and 2 h-PG values in predicting future risk of T2DM in elderly.
The study population consisted of 928 male volunteers ≥ 55 years old without diabetes who were involved in a retrospective-prospective cohort study over 20 years with a baseline fasting plasma glucose (FPG) and OGTT that included measurement of 1 h-PG and 2 h-PG. The predictive capabilities of FPG and 1 h-PG, 2 h-PG values obtained during OGTT alone and added to a clinical prediction model consisting of traditional diabetes risk factors were assessed.
Overall, 577 of all the 928 study participants (62%) developed T2DM over the 20-year follow-up. 1 h-PG and 2 h-PG values predicted T2DM and remained independent predictors of T2DM after adjusting for various traditional risk factors [HR = 1.269 (95% CI = 1.214-1.327), P < 0.001; HR = 1.269 (95% CI = 1.179-1.366), P < 0.001, respectively]. C-statistics for 1-h PG (C-statistics 0.794 [95% CI 0.765-0.823]) was significantly greater than that for 2-h PG (C-statistic 0.747 [95% CI 0.716-0.779]) in models adjusting for various traditional risk factors. 1 h-PG had the greatest area under the ROC curve (AUC, 0.766), which was greater than that of 2 h-PG (0.719).
1 h-PG is useful as a predictor of future development of T2DM independently of traditional risk factors in an elderly Chinese male population.
关于老年人群中1小时血糖(1 h - PG)浓度与2型糖尿病(T2DM)之间关联的报道较少。本研究旨在评估1 h - PG和2小时血糖(2 h - PG)值预测老年人群未来发生T2DM风险的效能。
研究人群包括928名年龄≥55岁且无糖尿病的男性志愿者,他们参与了一项为期20年的回顾性 - 前瞻性队列研究,基线时进行了空腹血糖(FPG)和口服葡萄糖耐量试验(OGTT),其中包括测量1 h - PG和2 h - PG。评估了FPG以及单独在OGTT期间获得的1 h - PG、2 h - PG值,以及将这些值添加到由传统糖尿病风险因素组成的临床预测模型后的预测能力。
总体而言,在20年的随访中,928名研究参与者中有577人(62%)发生了T2DM。1 h - PG和2 h - PG值可预测T2DM,在调整各种传统风险因素后,它们仍然是T2DM的独立预测因素[风险比(HR)= 1.269(95%置信区间(CI)= 1.214 - 1.327),P < 〇〇1;HR = 1.269(95% CI = 1.179 - 1.366),P < 〇〇1,分别]。在调整各种传统风险因素的模型中, 1小时血糖的C统计量(C统计量0.794 [95% CI 0.765 - 0.823])显著大于2小时血糖的C统计量(C统计量0.747 [95% CI 0,716 - 0.779])。1 h - PG在受试者工作特征曲线(ROC)下的面积最大(AUC,0.766),大于2 h - PG的面积(0.719)。
在老年中国男性人群中, 1 h - PG可独立于传统风险因素,作为预测未来T2DM发生的指标。