Using metabolic syndrome traits for efficient detection of impaired glucose tolerance

被引:51
作者
Meigs, JB
Williams, K
Sullivan, LM
Hunt, KJ
Haffner, SM
Stern, MP
Villalpando, CG
Perhanidis, JS
Nathan, DM
D'Agostino, RB
D'Agostino, RB
Wilson, PWF
机构
[1] Massachusetts Gen Hosp, Gen Internal Med Unit, Div Med Genet, Dept Med, Boston, MA 02114 USA
[2] Harvard Univ, Sch Med, Boston, MA 02115 USA
[3] Massachusetts Gen Hosp, Ctr Diabet, Dept Med, Boston, MA 02114 USA
[4] Univ Texas, Hlth Sci Ctr, Div Clin Epidemiol, Dept Med, San Antonio, TX 78285 USA
[5] Boston Univ, Dept Math & Stat, Stat & Consulting Unit, Boston, MA 02215 USA
[6] Amer British Coudray Hosp, Ctr Estudios Diabet, Mexico City, DF, Mexico
[7] Inst Mexicano Seguro Social, Hosp Gabriel Mancera, Unidades Invest Med Enfermedades Metab & Epidemio, Mexico City, DF, Mexico
[8] Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USA
[9] Boston Univ, Sch Med, Framingham, MA USA
[10] Framingham Heart Dis Epidemiol Study, Framingham, MA USA
关键词
D O I
10.2337/diacare.27.6.1417
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - Efficient detection of impaired glucose tolerance (IGT) is needed to implement type 2 diabetes prevention interventions. RESEARCH DESIGN AND METHODS - We assessed the capacity of the metabolic syndrome (MetS) to identify IGT in a cross-sectional analysis of 3,326 Caucasian Framingham Offspring Study (FOS), 1,1.68 Caucasian and 1,812 Mexican-American San Antonio Heart Study (SAHS), 1,983 Mexico City Diabetes Study (MCDS), and 452 Caucasian, 407 MexicanAmerican, and 290 African-American Insulin Resistance Atherosclerosis Study (IRAS) men and women aged 30-79 years who had a clinical examination and an oral glucose tolerance test (OGTT) during 1987-1996. Those with diabetes treatment or fasting plasma glucose greater than or equal to7.0 mmol/l were excluded (MetS was defined by Third Report of the National Cholesterol Education Program's Adult Treatment Panel criteria and IGT as 2-h postchallenge glucose [2hPG] greater than or equal to7.8 mmol/l). We calculated positive (PPV) and negative predictive values (NPV), population attributable risk percentages (PAR%), age- and sex-adjusted odds ratios (ORs), and areas under the receiver operating characteristic curve (AROCs) associated with MetS traits. RESULTS - Among FOS, SAHS, and MCDS subjects, 24-43% had MetS and 15-23% had IGT (including 2-5% with 2hPG greater than or equal to 11.1 mmolA). Among those with MetS, OR for IGT were 3-4, PPV were 0.24-0.41, NPV were 0.84-0.91, and PAR% were 30-40%. Among subjects with MetS defined by impaired fasting glucose (IFG) and any two other traits, OR for IGT were 9-24, PPV were 0.62-0.89, NPV were 0.78-0.87, and PAR% were 3-12%. Among IRAS subjects, 24-34% had MetS and 37-41% had IGT. Among those with MetS, ORs for IGT were 3-6, PPVs were 0.57-0.73, and NPVs were 0.67-0.72. In logistic regression models, IFG, large waist, and high triglycerides were independently associated with IGT (AROC 0.71-0.83) in all study populations.
引用
收藏
页码:1417 / 1426
页数:10
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