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首页> 外文期刊>Diabetes care >Accuracy of 1-Hour Plasma Glucose During the Oral Glucose Tolerance Test in Diagnosis of Type 2 Diabetes in Adults: A Meta-analysis
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Accuracy of 1-Hour Plasma Glucose During the Oral Glucose Tolerance Test in Diagnosis of Type 2 Diabetes in Adults: A Meta-analysis

机译：在成人2型糖尿病诊断中口服葡萄糖耐量试验期间1小时血浆葡萄糖的准确性：META分析

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OBJECTIVE One-hour plasma glucose (1-h PG) during the oral glucose tolerance test (OGTT) is an accurate predictor of type 2 diabetes. We performed a meta-analysis to determine the optimum cutoff of 1-h PG for detection of type 2 diabetes using 2-h PG as the gold standard. RESEARCH DESIGN AND METHODS We included 15 studies with 35,551 participants from multiple ethnic groups (53.8% Caucasian) and 2,705 newly detected cases of diabetes based on 2-h PG during OGTT. We excluded cases identified only by elevated fasting plasma glucose and/or HbA(1c). We determined the optimal 1-h PG threshold and its accuracy at this cutoff for detection of diabetes (2-h PG >= 11.1 mmol/L) using a mixed linear effects regression model with different weights to sensitivity/specificity (2/3, 1/2, and 1/3). RESULTS Three cutoffs of 1-h PG, at 10.6 mmol/L, 11.6 mmol/L, and 12.5 mmol/L, had sensitivities of 0.95, 0.92, and 0.87 and specificities of 0.86, 0.91, and 0.94 at weights 2/3, 1/2, and 1/3, respectively. The cutoff of 11.6 mmol/L (95% CI 10.6, 12.6) had a sensitivity of 0.92 (0.87, 0.95), specificity of 0.91 (0.88, 0.93), area under the curve 0.939 (95% confidence region for sensitivity at a given specificity: 0.904, 0.946), and a positive predictive value of 45%. CONCLUSIONS The 1-h PG of >= 11.6 mmol/L during OGTT has a good sensitivity and specificity for detecting type 2 diabetes. Prescreening with a diabetes-specific risk calculator to identify high-risk individuals is suggested to decrease the proportion of false-positive cases. Studies including other ethnic groups and assessing complication risk are warranted.
机译：目的口服糖耐量试验（OGTT）中1小时血糖（1h PG）是2型糖尿病的准确预测指标。我们进行了荟萃分析，以2-h PG为金标准，确定检测2型糖尿病的最佳1-h PG截止值。研究设计和方法我们纳入了15项研究，其中35551名参与者来自多个民族（53.8%为白种人），以及2705名在OGTT期间根据2-h PG新发现的糖尿病病例。我们排除了仅通过空腹血糖和/或HbA1c升高确定的病例。我们使用具有不同灵敏度/特异性权重（2/3、1/2和1/3）的混合线性效应回归模型确定了最佳1-h PG阈值及其在糖尿病检测截止点（2-h PG>=11.1 mmol/L）的准确性。结果在10.6 mmol/L、11.6 mmol/L和12.5 mmol/L条件下，1-h PG的三个临界值在重量为2/3、1/2和1/3时的敏感性分别为0.95、0.92和0.87，特异性分别为0.86、0.91和0.94。11.6 mmol/L（95%可信区间10.6,12.6）的临界值敏感性为0.92（0.87,0.95），特异性为0.91（0.88,0.93），曲线下面积为0.939（给定特异性下的敏感性95%置信区间：0.904,0.946），阳性预测值为45%。结论OGTT期间大于等于11.6 mmol/L的1-h PG对检测2型糖尿病具有良好的敏感性和特异性。建议使用糖尿病特定风险计算器进行预筛选，以识别高危个体，从而降低假阳性病例的比例。包括其他民族和评估并发症风险的研究是必要的。

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