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Cut‐off values of fasting and post‐load plasma glucose and HbA 1c for predicting Type 2 diabetes in community‐dwelling Japanese subjects: the Hisayama Study
Author(s) -
Mukai N.,
Doi Y.,
Ninomiya T.,
Hata J.,
Hirakawa Y.,
Fukuhara M.,
Iwase M.,
Kiyohara Y.
Publication year - 2012
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2011.03378.x
Subject(s) - medicine , decile , type 2 diabetes , diabetes mellitus , endocrinology , plasma glucose , hazard ratio , quartile , receiver operating characteristic , confounding , confidence interval , statistics , mathematics
Diabet. Med. 29, 99–106 (2012) Abstract Aims We examined the optimal cut‐off values of fasting plasma glucose, 2‐h post‐load glucose and HbA 1c for predicting Type 2 diabetes in community‐dwelling Japanese subjects. Methods A total of 1982 subjects without diabetes aged 40–79 years who underwent a 75‐g oral glucose tolerance test were followed prospectively for 14 years by annual health examination. Results During the follow‐up, 295 subjects developed Type 2 diabetes. Compared with the first decile, the crude hazard ratio for incident Type 2 diabetes was significantly higher in the fifth fasting plasma glucose decile [5.4–5.4 mmol/l (97–98 mg/dl)] or higher, in the seventh 2‐h post‐load glucose decile [6.9–7.2 mmol/l (124–131 mg/dl)] or higher, and in the fifth HbA 1c decile [34–36 mmol/mol (5.3–5.4%)] or higher. These associations remained substantially unchanged even after adjustment for confounding factors. The receiver operating characteristic curve analysis showed that the optimal cut‐off values for predicting Type 2 diabetes were 5.6 mmol/l (101 mg/dl) for fasting plasma glucose, 6.9 mmol/l (124 mg/dl) for 2‐h post‐load glucose and 37 mmol/mol (5.5%) for HbA 1c . In a stratified analysis, the cut‐off values were approximately 5.6 mmol/l (101 mg/dl) for fasting plasma glucose and 37 mmol/mol (5.5%) for HbA 1c , and these values were unchanged over BMI quartile levels, whereas the 2‐h post‐load glucose cut‐off values declined with decreasing BMI levels. Conclusions Our findings suggest that the cut‐off value for predicting Type 2 diabetes in the Japanese population is 5.6 mmol/l (101 mg/dl) for fasting plasma glucose and 37 mmol/mol (5.5%) for HbA 1c , while the 2‐h post‐load glucose cut‐off value is lower than the diagnostic criterion for impaired glucose tolerance.