Type 2 diabetes risk in persons with dysglycemia: the Framingham Offspring Study.
OBJECTIVE
Detection of risk of type 2 diabetes mellitus (T2DM) among adults with dysglycemia.


METHODS
We used a nested case-cohort prospective design to estimate risk of new diabetes (diabetes treatment or FPG ≥7.0 mmol/L) among 1004 Framingham Heart Study Offspring with baseline dysglycemia [fasting plasma glucose (FPG) 5.4-6.9 mmol/L and/or 2-h post glucose load level 7.8-11.0 mmol/L]. Using clinical characteristics previously shown to predict incident T2DM, we used logistic regression to estimate odds ratios (OR), p-values for predictors, and assessment of model discrimination.


RESULTS
At the end of 7 years follow-up there were 118 incident T2DM cases. In a model that included age, sex, elevated blood pressure or blood pressure treatment, lipid-lowering treatment and elevated triglycerides, we found the following additional characteristics to be independently associated with new T2DM: parental history of diabetes (OR 2.28, p=0.004); excess adiposity (BMI ≥30 kg/m(2) or waist circumference ≥101.6 cm) (OR 2.04, p=0.0005), and low HDL-C [<1.0 (men) or <1.3 mmol/L (women)] (OR 2.77, p<0.0001). The multivariable C-statistic for this model was 0.701, and with glycemic category information included, c=0.751.


CONCLUSIONS
The key non-glycemic traits that predicted later T2DM in adults with dysglycemia were parental history of diabetes, excess adiposity and low HDL-C.
EPICORE, Suite 1 North, Emory University School of Medicine, 1256 Briarcliff Rd., United States.
Peter W F
PW
Wilson
Ralph B
RB
D'Agostino
Caroline S
CS
Fox
Lisa M
LM
Sullivan
James B
JB
Meigs
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D008076:Cholesterol, HDL
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