title: A report on the diagnosis of intermediate hyperglycemia in Korea: A pooled analysis of four community-based cohort studies.
abstract: 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.
authors.affiliation: Department of Internal Medicine, School of Medicine Ewha Womans University, Seoul, Korea.
authors.forename: Jee-Young
authors.initials: JY
authors.lastname: Oh
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
authors.forename: Dae Jung
authors.initials: DJ
authors.lastname: Kim
authors.forename: Nan Hee
authors.initials: NH
authors.lastname: Kim
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Kim
authors.forename: Sung Dae
authors.initials: SD
authors.lastname: Moon
authors.forename: Hak Chul
authors.initials: HC
authors.lastname: Jang
authors.forename: Young Min
authors.initials: YM
authors.lastname: Cho
authors.forename: Kee-Ho
authors.initials: KH
authors.lastname: Song
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Ahn
authors.forename: Yeon-Ah
authors.initials: YA
authors.lastname: Sung
authors.forename: Joong-Yeol
authors.initials: JY
authors.lastname: Park
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.forename: Hong Kyu
authors.initials: HK
authors.lastname: Lee
authors.forename: Kyong Soo
authors.initials: KS
authors.lastname: Park
mesh_terms: 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
chemical_list: D001786:Blood Glucose