1. Enhanced prediction of abnormal glucose tolerance using an extended non-invasive risk score incorporating routine renal biochemistry.
- Author
-
He J, Fan B, Lau ESH, Chu N, Ng NYH, Leung KHT, Poon EWM, Kong APS, Ma RCW, Luk AOY, Chan JCN, and Chow E
- Subjects
- Humans, Blood Glucose, Glucose Tolerance Test, Risk Factors, Glucose Intolerance diagnosis, Diabetes Mellitus, Type 2 diagnosis
- Abstract
Introduction: Type 2 diabetes is preventable in subjects with impaired glucose tolerance based on 2-hour plasma glucose (2hPG) during 75 g oral glucose tolerance test (OGTT). We incorporated routine biochemistry to improve the performance of a non-invasive diabetes risk score to identify individuals with abnormal glucose tolerance (AGT) defined by 2hPG≥7.8 mmol/L during OGTT., Research Design and Methods: We used baseline data of 1938 individuals from the community-based "Better Health for Better Hong Kong - Hong Kong Family Diabetes Study (BHBHK-HKFDS) Cohort" recruited in 1998-2003. We incorporated routine biochemistry in a validated non-invasive diabetes risk score, and evaluated its performance using area under receiver operating characteristics (AUROC) with internal and external validation., Results: The AUROC of the original non-invasive risk score to predict AGT was 0.698 (95% CI, 0.662 to 0.733). Following additional inclusion of fasting plasma glucose, serum potassium, creatinine, and urea, the AUROC increased to 0.778 (95% CI, 0.744 to 0.809, p<0.001). Net reclassification improved by 31.9% (p<0.001) overall, by 30.8% among people with AGT and 1.1% among people without AGT. The extended model showed good calibration (χ
2 =11.315, p=0.1845) and performance on external validation using an independent data set (AUROC=0.722, 95% CI, 0.680 to 0.764)., Conclusions: The extended risk score incorporating clinical and routine biochemistry can be integrated into an electronic health records system to select high-risk subjects for evaluation of AGT using OGTT for prevention of diabetes., Competing Interests: Competing interests: EC has received research grants and/or honoraria for lectures from Sanofi, Lee Powder, Medtronic Diabetes, and Novartis. JCNC has received research grants and/or honoraria for consultancy and/or giving lectures from AstraZeneca, Bayer, Boehringer Ingelheim, Celltrion, Eli‐Lilly, Hua Medicine, Powder Pharmaceuticals, Merck Serono, Merck Sharp & Dohme, Pfizer, Servier, Sanofi and Viatris. AL has served as an advisory committee member for AstraZeneca, Boehringer Ingelheim, MSD, Novartis, Novo Nordisk, Sanofi and Amgen. RCWM has received research grants for clinical trials from AstraZeneca, Bayer, MSD, Novo Nordisk, Sanofi, Tricida and honoraria for consultancy or lectures from AstraZeneca, and Boehringer Ingelheim. APSK has received research grants and/or speaker honoraria from Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Kyowa Kirin, Eli‐Lilly, Merck Serono, Nestle, Novo Nordisk, Pfizer and Sanofi. All other authors declare that they have no competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)- Published
- 2024
- Full Text
- View/download PDF