The Cutoff Value of Fasting Plasma Glucose To Predict Future Diabetes in a Korean Population
Abstract Number: 1004-P
Authors: DONG-JUN KIM, NAM-HAN CHO, JUNG-HYUN NOH, HYUN-JIN KIM, MYUNG-SHIK LEE, MOON-KYU LEE, KWANG-WON KIM
Institutions: Koyang City, Korea; Suwon city, Korea; Seoul, Korea
Results: We tried to investigate the development of diabetes according to initial fating plasma glucose value in a Korean population and to estimate the cutoff value of fasting plasma glucose to predict future diabetes. The medical records of 3141 subjects (2127 men, 1014 women), who attended the Health Promotion Center in the Samsung Medical Center in both 1998 and 2003, were retrospectively examined for this analysis. Subjects with previous diagnosis of diabetes or FPG ≥ 7.0 mmol/l in 1998 were excluded. All subjects were classified into four groups according to their baseline value of fasting plasma glucose (group 1, FPG < 5.0, n=811; group 2, 5.0 ≤ FPG < 5.6, n=1319; group 3, 5.6 ≤ FPG < 6.1, n=720; group 4, 6.1 ≤ FPG < 7.0 mmol/l, n=291). Newly developed diabetes was diagnosed with medication history of current antidiabetic drugs and/or FPG ≥ 7.0 mmol/l. Five-year diabetes incidence according to baseline FPG categories were 0.5% in group 1, 1.0% in group 2, 3.8% in group 3 and 26.8% in group 4, respectively. In Cox regression analyses after controlling duration of follow-up, age, gender, BMI, change of BMI, and parental history of diabetes, there was no significant difference in the incidence of diabetes between group 1 and group 2. However, the incidence of diabetes in group 3, was significantly higher compared to that in group 1 [hazards ratio 5.94(2.04-17.26), p = 0.001] and the hazards ratio in group 4 for diabetes was 38.6 (13.8-108.08), p < 0.001, compared to group 1. Receiver operator characteristics curve analysis to investigate the optimal value of FPG to predict future diabetes (area under the curve 0.871, p < 0.001), showed that 5.9 mmol/l of FPG was the optimal value (sensitivity 0.74, specificity 0.89 and positive predictive value 0.21). The data showed that risk of future diabetes started to increase at the level of FPG < 6.1 mmol/l and strongly suggested the significance of concentrated effort to reduce the diabetes risk factors in the earlier stage of impaired fasting glucose.