Accuracy of 1-hour plasma glucose during the oral glucose tolerance test in diagnosis of type 2 diabetes in adults : a meta-analysis
Ahuja, Vasudha; Aronen, Pasi; Pramodkumar, T. A.; Looker, Helen; Chetrit, Angela; Bloigu, Aini H.; Juutilainen, Auni; Bianchi, Cristina; La Sala, Lucia; Anjana, Ranjit Mohan; Pradeepa, Rajendra; Venkatesan, Ulagamadesan; Jebarani, Sarvanan; Baskar, Viswanathan; Fiorentino, Teresa Vanessa; Timpel, Patrick; DeFronzo, Ralph A.; Ceriello, Antonio; Del Prato, Stefano; Abdul-Ghani, Muhammad; Keinänen-Kiukaanniemi, Sirkka; Dankner, Rachel; Bennett, Peter H.; Knowler, William C.; Schwarz, Peter; Sesti, Giorgio; Oka, Rie; Mohan, Viswanathan; Groop, Leif; Tuomilehto, Jaakko; Ripatti, Samuli; Bergman, Michael; Tuomi, Tiinamaija (2021-03-15)
Ahuja, V., Aronen, P., Pramodkumar, T. A., Looker, H., Chetrit, A., Bloigu, A. H., Juutilainen, A., Bianchi, C., La Sala, L., Anjana, R. M., Pradeepa, R., Venkatesan, U., Jebarani, S., Baskar, V., Fiorentino, T. V., Timpel, P., DeFronzo, R. A., Ceriello, A., Del Prato, S., … Tuomi, T. (2021). Accuracy of 1-hour plasma glucose during the oral glucose tolerance test in diagnosis of type 2 diabetes in adults: A meta-analysis. Diabetes Care, 44(4), 1062–1069. https://doi.org/10.2337/dc20-1688
© 2021 by the American Diabetes Association. The final authenticated version is available online at https://doi.org/10.2337/dc20-1688.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2022022821015
Tiivistelmä
Abstract
Objective: One-hour plasma glucose (1-h PG) during the oral glucose tolerance test (OGTT) is an accurate predictor of type 2 diabetes. We performed a meta-analysis to determine the optimum cutoff of 1-h PG for detection of type 2 diabetes using 2-h PG as the gold standard.
Research design and methods: We included 15 studies with 35,551 participants from multiple ethnic groups (53.8% Caucasian) and 2,705 newly detected cases of diabetes based on 2-h PG during OGTT. We excluded cases identified only by elevated fasting plasma glucose and/or HbA1c. We determined the optimal 1-h PG threshold and its accuracy at this cutoff for detection of diabetes (2-h PG ≥11.1 mmol/L) using a mixed linear effects regression model with different weights to sensitivity/specificity (2/3, 1/2, and 1/3).
Results: Three cutoffs of 1-h PG, at 10.6 mmol/L, 11.6 mmol/L, and 12.5 mmol/L, had sensitivities of 0.95, 0.92, and 0.87 and specificities of 0.86, 0.91, and 0.94 at weights 2/3, 1/2, and 1/3, respectively. The cutoff of 11.6 mmol/L (95% CI 10.6, 12.6) had a sensitivity of 0.92 (0.87, 0.95), specificity of 0.91 (0.88, 0.93), area under the curve 0.939 (95% confidence region for sensitivity at a given specificity: 0.904, 0.946), and a positive predictive value of 45%.
Conclusions: The 1-h PG of ≥11.6 mmol/L during OGTT has a good sensitivity and specificity for detecting type 2 diabetes. Prescreening with a diabetes-specific risk calculator to identify high-risk individuals is suggested to decrease the proportion of false-positive cases. Studies including other ethnic groups and assessing complication risk are warranted.
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