title: Predictive Value of Glucose Parameters Obtained From Oral Glucose Tolerance Tests in Identifying Individuals at High Risk for the Development of Diabetes in Korean Population.
abstract: Previous studies suggest that the future risk for type 2 diabetes is not similar among subjects in the same glucose tolerance category. In this study, we aimed to evaluate simple intuitive indices to identify subjects at high risk for future diabetes development by using 0, 30, 120 minute glucose levels obtained during 75 g OGTTs from participants of a prospective community-based cohort in Korea.Among subjects enrolled at the Chungju Metabolic disease Cohort, those who performed an OGTT between 2007 and 2010 and repeated the test between 2011 and 2014 were recruited after excluding subjects with diabetes at baseline. Subjects were categorized according to their 30 minute glucose (G30) and the difference between 120 and 0 minute glucose (G(120-0)) levels with cutoffs of 9.75 and 2.50 mmol/L, respectively.Among 1126 subjects, 117 (10.39%) developed type 2 diabetes after 4 years. In diabetes nonconverters, increased insulin resistance was accompanied by compensatory insulin secretion, but this was not observed in converters during 4 years of follow-up. Subjects with G(120-0) ≥ 2.50 mmol/L or G30 ≥ 9.75 mmol/L demonstrated lower degrees of insulin secretion, higher degrees of insulin resistance, and ∼6-fold higher risk of developing future diabetes compared to their lower counterparts after adjustment for possible confounding factors. Moreover, subjects with high G(120-0) and high G30 demonstrated 22-fold higher risk for diabetes development compared to subjects with low G(120-0) and low G30.By using the G(120-0) and G30 values obtained during the OGTT, which are less complicated measurements than previously reported methods, we were able to select individuals at risk for future diabetes development. Further studies in different ethnicities are required to validate our results.
authors.affiliation: From the Division of Endocrinology and Metabolism (HKY, S-HL, K-HY, MR, H-SK, M-IK), Department of Internal Medicine, College of Medicine, The Catholic University of Korea; Division of Endocrinology and Metabolism (HKY, S-HL, K-HY, M-IK), Department of Internal Medicine, Seoul St. Mary's Hospital; Department of Preventive Medicine (H-SH, H-WY, W-CL), College of Medicine, The Catholic University of Korea; Catholic Institute of U-Healthcare (J-HL), The Catholic University of Korea, Seoul, Korea; Epidemiology Branch (Y-MP), National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC; Division of Endocrinology and Metabolism (H-SK), Department of Internal Medicine, Yeouido St.Mary's Hospital; and Division of Endocrinology and Metabolism (H-YS), Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Hae Kyung
authors.initials: HK
authors.lastname: Yang
authors.forename: Hee-Sung
authors.initials: HS
authors.lastname: Ha
authors.forename: Marie
authors.initials: M
authors.lastname: Rhee
authors.forename: Jin-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Yong-Moon
authors.initials: YM
authors.lastname: Park
authors.forename: Hyuk-Sang
authors.initials: HS
authors.lastname: Kwon
authors.forename: Hyeon-Woo
authors.initials: HW
authors.lastname: Yim
authors.forename: Moo-Il
authors.initials: MI
authors.lastname: Kang
authors.forename: Won-Chul
authors.initials: WC
authors.lastname: Lee
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Son
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Kun-Ho
authors.initials: KH
authors.lastname: Yoon
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D015994:Incidence; D007328:Insulin / Q000097:blood; D008297:Male; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin