title: Performance of homeostasis model assessment and serum high-sensitivity C-reactive protein for prediction of isolated post-load hyperglycaemia.
abstract: OBJECTIVE
  To evaluate whether homeostasis model assessment and high-sensitivity C-reactive protein improve the prediction of isolated post-load hyperglycaemia.
  
  
  METHODS
  The subjects were 1458 adults without self-reported diabetes recruited between 2006 and 2010. Isolated post-load hyperglycaemia was defined as fasting plasma glucose < 7 mmol/l and 2-h post-load plasma glucose ≥ 11.1 mmol/l. Risk scores of isolated post-load hyperglycaemia were constructed by multivariate logistic regression. An independent group (n = 154) was enrolled from 2010 to 2011 to validate the models' performance.
  
  
  RESULTS
  One hundred and twenty-three subjects (8.28%) were newly diagnosed as having diabetes mellitus. Among those with undiagnosed diabetes, 64 subjects (52%) had isolated post-load hyperglycaemia. Subjects with isolated post-load hyperglycaemia were older, more centrally obese and had higher blood pressure, HbA(1c), fasting plasma glucose, triglycerides, LDL cholesterol, high-sensitivity C-reactive protein and homeostasis model assessment of insulin resistance and lower homeostasis model assessment of β-cell function than those without diabetes. The risk scores included age, gender, BMI, homeostasis model assessment, high-sensitivity C-reactive protein and HbA(1c). The full model had high sensitivity (84%) and specificity (87%) and area under the receiver operating characteristic curve (0.91), with a cut-off point of 23.81; validation in an independent data set showed 88% sensitivity, 77% specificity and an area under curve of 0.89.
  
  
  CONCLUSIONS
  Over half of those with undiagnosed diabetes had isolated post-load hyperglycaemia. Homeostasis model assessment and high-sensitivity C-reactive protein are useful to identify subjects with isolated post-load hyperglycaemia, with improved performance over fasting plasma glucose or HbA(1c) alone.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Lai
authors.forename: H-Y
authors.initials: HY
authors.lastname: Li
authors.forename: C-S
authors.initials: CS
authors.lastname: Hung
authors.forename: M-S
authors.initials: MS
authors.lastname: Lin
authors.forename: S-R
authors.initials: SR
authors.lastname: Shih
authors.forename: W-Y
authors.initials: WY
authors.lastname: Ma
authors.forename: C-H
authors.initials: CH
authors.lastname: Hua
authors.forename: L-M
authors.initials: LM
authors.lastname: Chuang
authors.forename: F-C
authors.initials: FC
authors.lastname: Sung
authors.forename: J-N
authors.initials: JN
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin