Prediction of diabetes with body mass index, oral glucose tolerance test and islet cell autoantibodies in a regional population.
OBJECTIVE
Our aim was to test the hypothesis that a combination of markers for Type 1 diabetes (glutamate decarboxylase and IA-2 autoantibodies) and for Type 2 diabetes [oral glucose tolerance test (OGTT) and body mass index (BMI)], would predict clinical diabetes in a regional population.


METHODS
A population-based follow-up cohort study.


METHODS
Participants visited the primary health care centre in Lycksele, Sweden in 1988-92.


METHODS
A cohort of 2278 subjects (M/F 1149/1129) who were studied at follow-up in 1998. At base line there were 2314 subjects (M/F 1167/1147) who participated in the Västerbotten Intervention Program on their birthday when turning either 30, 40, 50 or 60 years of age. Main outcome measurements. A clinically diagnosed diabetes at follow-up when the medical records were reviewed for diagnosis of diabetes. At base line, the participants were subjected to a standard OGTT and their BMI determined along with the autoantibodies.


RESULTS
At follow-up, 42/2278 (1.8%, 95% CI 1.2-2.3) (M/F 23/19) had developed diabetes: 41 subjects were clinically classified with Type 2 and one with Type 1 diabetes. There was no significant relation between autoantibody levels at base line and diabetes at follow-up. Stepwise multiple logistic regression showed that the odds ratio for developing diabetes was 10.8 (95% CI 6.3-18.9) in subjects in the fourth quartile of BMI (BMI > 27) compared with 7.8 (95% CI 4.8-12.6) in the fourth quartile of 2-h plasma glucose (>7.5 mmol L(-1)) and 7.2 (95% CI 4.8-11.4) in the fourth quartile of the fasting plasma glucose (>5.6 mmol L(-1)).


CONCLUSIONS
Islet cell autoantibodies did not predict diabetes at follow-up. BMI measured at base line was as effective as 2-h plasma glucose and fasting plasma glucose to predict diabetes in this adult population.
Rolandsson
O
O
Department of Public Health and Clinical Medicine, Umeå University, Sweden. olov.rolandsson@fammed.umu.se
Hägg
E
E
Nilsson
M
M
Hallmans
G
G
Mincheva-Nilsson
L
L
Lernmark
A
A
D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D015992:Body Mass Index; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve
D001323:Autoantibodies