Fasting plasma glucose outperformed 1-hour plasma glucose in predicting diabetes incidence in individuals with family history of young-onset type 2 diabetes.

IF 4.1 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2025-06-22 DOI:10.1136/bmjdrc-2024-004749

Chun Kwan O, Baoqi Fan, Jane Py Ho, Eric S H Lau, Gary Tc Ko, Juliana Nm Lui, Elaine Chow, Alice Pik Shan Kong, Ronald Ching Wan Ma, Andrea Luk, Juliana C N Chan

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Abstract

Introduction: Family history (FmH) of young-onset type 2 diabetes (YOD) and 1-hour plasma glucose (PG) during the 75-g oral glucose tolerance test predicts incident diabetes, although their interactions remain unknown.

Research design and methods: In a workforce cohort established in 1998-2003, we ascertained their glycemic status in 2012-2014. We examined the interaction between FmH-YOD and 1-hour PG in predicting diabetes and used receiver operating characteristics (ROC) analysis to compare the performance of 1-hour PG in participants with or without FmH-YOD.

Results: Among 583 participants (median age (IQR)=41 (36-47) years, 43.7% men, body mass index=23.3 (21.2-26) kg/m², 40.3% (n=235) had FmH-YOD, 1-hour PG=8.1 (6.4-10.1) mmol/L), 99 (17%) had developed diabetes at a follow-up of 12.1 (11.3-13.1) years. In the FmH-YOD group, 45% in the high 1-hour PG group and 17% in the normal 1-hour PG group developed diabetes. The respective figures were 16% and 1.8% in the FmH-NONE group. Both FmH-YOD and 1-hour PG predicted diabetes with a negative interaction between FmH-YOD and 1-hour PG (OR 0.72, 95% CI 0.55 to 0.93, p=0.013). Compared with (FmH-NONE/normal 1-hour PG) group, the ORs of incident diabetes in (FmH-NONE/high 1-hour PG), (FmH-YOD/normal 1-hour PG), (FmH-YOD/high 1-hour PG) groups were 7.4 (95% CI 1.6 to 35.1, p=0.011), 18 (95% CI 3.3 to 98.1, p=0.001) and 28.2 (95% CI 5.5 to 145.9, p<0.001), respectively. In ROC analysis, the C-statistics of 1-hour PG dropped from 0.83 (95% CI 0.76 to 0.90, p<0.001) in the FmH-NONE group to 0.69 (95% CI 0.62 to 0.76, p<0.001) in the FmH-YOD group (difference=0.14 (95% CI 0.04-0.24), p=0.006) where fasting PG (FPG) was the best predictor (0.792 (95% CI 0.730-0.853), p<0.001).

Conclusions: FPG outperformed 1-hour PG in predicting incident diabetes in people with FmH-YOD, calling for precise classification and preventive strategies.

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在预测年轻发病2型糖尿病家族史个体的糖尿病发病率方面，空腹血糖优于1小时血糖。

简介：年轻发病2型糖尿病（YOD）家族史（FmH）和75克口服葡萄糖耐量试验时1小时血糖（PG）预测糖尿病的发生，尽管它们之间的相互作用尚不清楚。研究设计和方法：在1998-2003年建立的劳动力队列中，我们确定了他们2012-2014年的血糖状况。我们研究了FmH-YOD和1小时PG在预测糖尿病方面的相互作用，并使用受试者工作特征（ROC）分析来比较有或没有FmH-YOD的参与者1小时PG的表现。结果：在583名参与者中(中位年龄(IQR)=41（36-47）岁，43.7%为男性，体重指数=23.3 (21.2-26)kg/m2, 40.3% （n=235）患有FmH-YOD， 1小时PG=8.1 (6.4-10.1) mmol/L), 99（17%）在随访12.1（11.3-13.1）年时发生糖尿病。在FmH-YOD组中，高1小时PG组45%，正常1小时PG组17%发生糖尿病。FmH-NONE组分别为16%和1.8%。FmH-YOD和1小时PG预测糖尿病，FmH-YOD和1小时PG负交互作用（OR 0.72, 95% CI 0.55 ~ 0.93, p=0.013）。与（FmH-NONE/正常1小时PG）组相比，（FmH-NONE/高1小时PG）、（FmH-YOD/正常1小时PG）、（FmH-YOD/高1小时PG）组糖尿病发生率的or分别为7.4 （95% CI 1.6 ~ 35.1, p=0.011）、18 （95% CI 3.3 ~ 98.1, p=0.001）和28.2 （95% CI 5.5 ~ 145.9, p）。结论：FPG在预测FmH-YOD患者糖尿病发生率方面优于1小时PG，需要精确的分类和预防策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.