title: The performance of risk scores and hemoglobin A1c to find undiagnosed diabetes with isolated postload hyperglycemia.
abstract: The aim of this study is to develop strategies to screen diabetic subjects with isolated postload hyperglycemia (IPH) in Chinese population. We included 1175 adult subjects who did not report diabetes were included. Diabetes was diagnosed by oral glucose tolerance tests. IPH was defined as fasting plasma glucose (FPG)<7 mmol/l and 2-hour post-load plasma glucose (2hPG) greater than 11.1 mmol/l. Using FPG criteria, only 59.8% of diabetic subjects were not identified, showing a poor agreement between FPG and 2hPG criteria (kappa 0.294). Age, FPG, total cholesterol, triglycerides, blood pressure, body mass index, HbA1c and medication for hypertension were associated factors for IPH. Four scores were constructed using all these factors, age and blood test results, age and HbA1c, and data from non-invasive examinations, respectively. The area under the ROC curve were 0.9296(95%CI 0.8948-0.9643), 0.9111(95%CI 0.8713-0.9508), 0.8902(95%CI 0.8341-0.9646), 0.8924(95%CI 0.7835-0.8753), and 0.8654(95%CI 0.7963-0.9345) for score 1, 2, 3, 4, and HbA1c, respectively. The sensitivity of all four risk scores to detect IPH was better than that of impaired fasting glucose (IFG). The sensitivity and specificity of HbA1c at cutoff 6.2% for detecting IPH was also better than that of IFG. In conclusion, the risk scores and HbA1c are useful to identify subjects with undiagnosed IPH, with better performance than IFG.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hung-Yuan
authors.initials: HY
authors.lastname: Li
authors.forename: Mao-Shin
authors.initials: MS
authors.lastname: Lin
authors.forename: Shyang-Rong
authors.initials: SR
authors.lastname: Shih
authors.forename: Cyue-Huei
authors.initials: CH
authors.lastname: Hua
authors.forename: Yu-Lai
authors.initials: YL
authors.lastname: Liu
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Chuang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
authors.forename: Jin-Chuan
authors.initials: JC
authors.lastname: Lee
authors.forename: Ching-Hsiang
authors.initials: CH
authors.lastname: Chiao
authors.forename: Jung-Nan
authors.initials: JN
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D044466:Asian People; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin