Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
Department of Biostatistics and Computing, Yonsei University, Seoul, 03722, Republic of Korea.
Endocrine. 2024 Nov;86(2):528-538. doi: 10.1007/s12020-024-03876-3. Epub 2024 May 21.
Diabetes mellitus (DM) is a global health concern linked to various complications, including cardiovascular disease (CVD). However, long-term follow-up studies on the risk of DM and CVD using different blood glucose assessment methods in the general Korean population are lacking. This study aimed to assess the predictive abilities of fasting plasma glucose (FPG), 2-h oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) for new-onset DM and high CVD risk in a middle-aged and older Korean population.
This study used data from the Korean Genome and Epidemiology Study, a population-based prospective cohort. Blood sugar measures (FPG, OGTT, and HbA1c) were examined. The primary endpoint was the development of new-onset DM, and CVD risk was evaluated using the Framingham risk score. The predictive abilities for new-onset DM based on glycemic values were evaluated using Harrell's Concordance index and 95% confidence intervals.
Among the 10,030 participants, data of 6813 participants without DM at baseline were analyzed. The study revealed that OGTT outperformed FPG and HbA1c in predicting new-onset DM. The combination of FPG and HbA1c did not significantly enhance predictions for DM compared with OGTT alone. OGTT also outperformed FPG and HbA1c in predicting high CVD risk, and this difference remained significant even after adjusting for additional confounders.
OGTT has superior predictive capabilities in identifying new-onset DM and high CVD risk in the Korean population. This suggests that relying solely on individual blood sugar measures may be insufficient for assessing DM and CVD risks.
糖尿病（DM）是一个全球性的健康问题，与各种并发症有关，包括心血管疾病（CVD）。然而，在一般韩国人群中，使用不同血糖评估方法对 DM 和 CVD 风险进行长期随访的研究较少。本研究旨在评估空腹血糖（FPG）、2 小时口服葡萄糖耐量试验（OGTT）和糖化血红蛋白（HbA1c）对中年和老年韩国人群中新发 DM 和高 CVD 风险的预测能力。
本研究使用了韩国基因组与流行病学研究的数据，这是一项基于人群的前瞻性队列研究。检测了血糖测量值（FPG、OGTT 和 HbA1c）。主要终点是新发 DM 的发生，CVD 风险使用 Framingham 风险评分进行评估。使用 Harrell 一致性指数和 95%置信区间评估基于血糖值的新发 DM 的预测能力。
在 10030 名参与者中，对基线时无 DM 的 6813 名参与者的数据进行了分析。研究表明，OGTT 在预测新发 DM 方面优于 FPG 和 HbA1c。FPG 和 HbA1c 联合使用并不能显著提高 OGTT 单独预测 DM 的效果。OGTT 在预测高 CVD 风险方面也优于 FPG 和 HbA1c，即使在调整了其他混杂因素后，这种差异仍然显著。
OGTT 在识别韩国人群中的新发 DM 和高 CVD 风险方面具有更好的预测能力。这表明仅依赖于单个血糖测量值可能不足以评估 DM 和 CVD 风险。
