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Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes
OBJECTIVE: In this investigation we evaluated nine metabolic indexes from intravenous glucose tolerance tests (IVGTTs) and oral glucose tolerance tests (OGTTs) in an effort to determine their prognostic performance in predicting the development of type 1 diabetes in those with moderate risk, as defi...
Autores principales: | , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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American Diabetes Association
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992179/ https://www.ncbi.nlm.nih.gov/pubmed/20807869 http://dx.doi.org/10.2337/dc10-0802 |
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author | Xu, Ping Wu, Yougui Zhu, Yiliang Dagne, Getachew Johnson, Giffe Cuthbertson, David Krischer, Jeffrey P. Sosenko, Jay M. Skyler, Jay S. |
author_facet | Xu, Ping Wu, Yougui Zhu, Yiliang Dagne, Getachew Johnson, Giffe Cuthbertson, David Krischer, Jeffrey P. Sosenko, Jay M. Skyler, Jay S. |
author_sort | Xu, Ping |
collection | PubMed |
description | OBJECTIVE: In this investigation we evaluated nine metabolic indexes from intravenous glucose tolerance tests (IVGTTs) and oral glucose tolerance tests (OGTTs) in an effort to determine their prognostic performance in predicting the development of type 1 diabetes in those with moderate risk, as defined by familial relation to a type 1 diabetic individual, a positive test for islet cell antibodies and insulin autoantibody, but normal glucose tolerance. RESEARCH DESIGN AND METHODS: Subjects (n = 186) who had a projected risk of 25–50% for developing type 1 diabetes within 5 years were followed until clinical diabetes onset or the end of the study as part of the Diabetes Prevention Trial–Type 1. Prognostic performance of the metabolic indexes was determined using receiver operating characteristic (ROC) curve and survival analyses. RESULTS: Two-hour glucose from an OGTT most accurately predicted progression to disease compared with all other metabolic indicators with an area under the ROC curve of 0.67 (95% CI 0.59–0.76), closely followed by the ratio of first-phase insulin response (FPIR) to homeostasis model assessment of insulin resistance (HOMA-IR) with an area under the curve value of 0.66. The optimal cutoff value for 2-h glucose (114 mg/dl) maintained sensitivity and specificity values >0.60. The hazard ratio for those with 2-h glucose ≥114 mg/dl compared with those with 2-h glucose <114 mg/dl was 2.96 (1.67–5.22). CONCLUSIONS: The ratio of FPIR to HOMA-IR from an IVGTT provided accuracy in predicting the development of type 1 diabetes similar to that of 2-h glucose from an OGTT, which, because of its lower cost, is preferred. The optimal cutoff value determined for 2-h glucose provides additional guidance for clinicians to identify subjects for potential prevention treatments before the onset of impaired glucose tolerance. |
format | Text |
id | pubmed-2992179 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-29921792011-12-01 Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes Xu, Ping Wu, Yougui Zhu, Yiliang Dagne, Getachew Johnson, Giffe Cuthbertson, David Krischer, Jeffrey P. Sosenko, Jay M. Skyler, Jay S. Diabetes Care Original Research OBJECTIVE: In this investigation we evaluated nine metabolic indexes from intravenous glucose tolerance tests (IVGTTs) and oral glucose tolerance tests (OGTTs) in an effort to determine their prognostic performance in predicting the development of type 1 diabetes in those with moderate risk, as defined by familial relation to a type 1 diabetic individual, a positive test for islet cell antibodies and insulin autoantibody, but normal glucose tolerance. RESEARCH DESIGN AND METHODS: Subjects (n = 186) who had a projected risk of 25–50% for developing type 1 diabetes within 5 years were followed until clinical diabetes onset or the end of the study as part of the Diabetes Prevention Trial–Type 1. Prognostic performance of the metabolic indexes was determined using receiver operating characteristic (ROC) curve and survival analyses. RESULTS: Two-hour glucose from an OGTT most accurately predicted progression to disease compared with all other metabolic indicators with an area under the ROC curve of 0.67 (95% CI 0.59–0.76), closely followed by the ratio of first-phase insulin response (FPIR) to homeostasis model assessment of insulin resistance (HOMA-IR) with an area under the curve value of 0.66. The optimal cutoff value for 2-h glucose (114 mg/dl) maintained sensitivity and specificity values >0.60. The hazard ratio for those with 2-h glucose ≥114 mg/dl compared with those with 2-h glucose <114 mg/dl was 2.96 (1.67–5.22). CONCLUSIONS: The ratio of FPIR to HOMA-IR from an IVGTT provided accuracy in predicting the development of type 1 diabetes similar to that of 2-h glucose from an OGTT, which, because of its lower cost, is preferred. The optimal cutoff value determined for 2-h glucose provides additional guidance for clinicians to identify subjects for potential prevention treatments before the onset of impaired glucose tolerance. American Diabetes Association 2010-12 2010-08-31 /pmc/articles/PMC2992179/ /pubmed/20807869 http://dx.doi.org/10.2337/dc10-0802 Text en © 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Original Research Xu, Ping Wu, Yougui Zhu, Yiliang Dagne, Getachew Johnson, Giffe Cuthbertson, David Krischer, Jeffrey P. Sosenko, Jay M. Skyler, Jay S. Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes |
title | Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes |
title_full | Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes |
title_fullStr | Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes |
title_full_unstemmed | Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes |
title_short | Prognostic Performance of Metabolic Indexes in Predicting Onset of Type 1 Diabetes |
title_sort | prognostic performance of metabolic indexes in predicting onset of type 1 diabetes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992179/ https://www.ncbi.nlm.nih.gov/pubmed/20807869 http://dx.doi.org/10.2337/dc10-0802 |
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