A report on the diagnosis of intermediate hyperglycemia in Korea: A pooled analysis of four community-based cohort studies.
Many studies show poor agreement between fasting plasma glucose (FPG)-based and 2-h postchallenge glucose (2-h PG)-based criteria to assess glucose metabolism. We examined the rate of agreement between FPG- and 2-h PG-based criteria in the diagnosis of intermediate hyperglycemia in four representative cohort studies in South Korea and compared the clinical characteristics and biochemical parameters in subjects with impaired fasting glucose (IFG) according to their FPG values. Of 6234 subjects from four population-based studies performed from 1993 to 2000, 4610 individuals with data from a 75g oral glucose tolerance test (OGTT) and no previous history of diabetes were selected. We examined the concordance rate between the FPG and 2-h PG-based criteria. We also investigated the differences in the clinical characteristics and biochemical parameters between individuals with IFG according to their FPG values. The fasting and 2-h PG criteria had large discordance rates in the diagnosis of diabetes and impaired glucose tolerance (IGT) in Korean adults. When individuals with IFG were classified into stage 1 [5.6-6.1mmol/L (100-109mg/dL)] and stage 2 [6.1-7.0mmol/L (110-125mg/dL)] IFG, individuals with stage 2 IFG are more obese and had higher blood pressure and total cholesterol and triglycerides concentrations compared with those with stage 1 IFG. In addition, more individuals with stage 2 IFG were with diabetes as determined by a 2-h PG>or=11.1mmol/L (14.1% vs. 1.9%) (P<0.05). Considering the poorer metabolic profile and higher percentage of people with diabetes by OGTT, these data indicate that, in the Korean population, individuals with stage 2 IFG should be treated differently from those with stage 1 IFG. To detect more cases of diabetes, the OGTT is recommended for all individuals with stage 2 IFG and cases with stage 1 IFG with some additional risk factors for diabetes.
Oh
Jee-Young
JY
Department of Internal Medicine, School of Medicine Ewha Womans University, Seoul, Korea.
Lim
Soo
S
Kim
Dae Jung
DJ
Kim
Nan Hee
NH
Kim
Dong Jun
DJ
Moon
Sung Dae
SD
Jang
Hak Chul
HC
Cho
Young Min
YM
Song
Kee-Ho
KH
Ahn
Chul Woo
CW
Sung
Yeon-Ah
YA
Park
Joong-Yeol
JY
Shin
Chol
C
Lee
Hong Kyu
HK
Park
Kyong Soo
KS
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D049629:Waist-Hip Ratio
D001786:Blood Glucose