title: Age, BMI, and race are less important than random plasma glucose in identifying risk of glucose intolerance: the Screening for Impaired Glucose Tolerance Study (SIGT 5).
abstract: OBJECTIVE
  Age, BMI, and race/ethnicity are used in National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and American Diabetes Association (ADA) guidelines to prompt screening for pre-diabetes and diabetes, but cutoffs have not been evaluated rigorously.
  
  
  METHODS
  Random plasma glucose (RPG) was measured and 75-g oral glucose tolerance tests were performed in 1,139 individuals without known diabetes. Screening performance was assessed by logistic regression and area under the receiver operating characteristic curve (AROC).
  
  
  RESULTS
  NIDDK/ADA indicators age >45 years and BMI >25 kg/m(2) provided significant detection of both diabetes and dysglycemia (both AROCs 0.63), but screening was better with continuous-variable models of age, BMI, and race and better still with models of age, BMI, race, sex, and family history (AROC 0.78 and 0.72). However, screening was even better with RPG alone (AROCs 0.81 and 0.72). RPG >125 mg/dl could be used to prompt further evaluation with an OGTT.
  
  
  CONCLUSIONS
  Use of age, BMI, and race/ethnicity in guidelines for screening to detect diabetes and pre-diabetes may be less important than evaluation of RPG. RPG should be investigated further as a convenient, inexpensive screen with good predictive utility.
authors.affiliation: Division of Endocrinology and Metabolism, Emory University, Atlanta, Georgia 30322, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Ziemer
authors.forename: Paul
authors.initials: P
authors.lastname: Kolm
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
authors.forename: Viola
authors.initials: V
authors.lastname: Vaccarino
authors.forename: Mary K
authors.initials: MK
authors.lastname: Rhee
authors.forename: Jane M
authors.initials: JM
authors.lastname: Caudle
authors.forename: Jade M
authors.initials: JM
authors.lastname: Irving
authors.forename: David D
authors.initials: DD
authors.lastname: Koch
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis* / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D054586:National Institute of Diabetes and Digestive and Kidney Diseases (U.S.); D016017:Odds Ratio; D012016:Reference Values; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D001786:Blood Glucose