Miura K, Nakagawa H, Tabata M, Morikawa Y, Nishijo M, Senma M, Kawano S; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1995; 11: Abstract No. 176.

Kanazawa Medical University, Ishikawa, Japan.

OBJECTIVE: To investigate factors which may affect the accuracy of screening for diabetes mellitus (DM) using fasting plasma glucose concentration (FPG). The factors investigated were age, body mass index (BMI), alcohol consumption, and some indexes concerning insulin. METHODS: The study subjects were 1146 Japanese (942 men and 204 women), aged 27 to 77, who visited Kanazawa Medical University Hospital for an intensive medical check-up. All the subjects were examined by 75-g oral glucose tolerance tests, and DM and normal glucose tolerance were defined using WHO criteria. BMI, volume of alcohol consumption per week, and fasting plasma insulin concentration were also obtained. Indexes of beta-cell function and insulin resistance by homeostasis model assessment (HOMA) were calculated from fasting plasma insulin and FPG. To assess the accuracy of DM screening using FPG, the analysis by means of drawing receiver operating characteristics (ROC) curves was performed. ROC curves were drawn by two or three categories of each factor by calculating sensitivity and false positive rate of the diverse cut-off points of FPG in screening DM from normal glucose tolerance, and variation of the accuracy of DM screening in each factor was evaluated. RESULTS: By 75-g oral glucose tolerance tests, 79 subjects (6.9%) were defined as DM and 833 subjects (72.7%) were defined as normal glucose tolerance. As regards age, ROC curve in subjects less than 50 years old was located to the left of that in subjects of 50 years old or over, which showed that the accuracy of DM screening was lower in older subjects. When the subjects were divided into three categories of BMI (-21.9 kg/m2, 22-24.9 kg/m2, 25- kg/m2), the accuracy of DM screening, assessed by ROC curves, was obviously lower in subjects with higher BMI. As regards alcohol consumption, the accuracy of DM screening was obviously lower in heavy drinkers (400 ml ethanol/week or over). To reveal the cause of these variations of the accuracy, we compared ROC curves by higher and lower categories of beta-cell function and insulin resistance by HOMA. Although the curves were somewhat different by categories, we could not explain the variations of the accuracy. CONCLUSIONS: Using the analysis by ROC curves, we demonstrated the variation of the accuracy of DM screeningby FPG. Lower accuracy were observed in older subjects, in obese subjects, and in heavy drinkers.

Publication Types:

• Meeting Abstracts

Keywords:

• Asian Continental Ancestry Group
• Body Mass Index
• Diabetes Mellitus
• Fasting
• Female
• Glucose
• Glucose Intolerance
• Glucose Tolerance Test
• Homeostasis
• Humans
• Insulin
• Insulin Resistance
• Islets of Langerhans
• Male
• Mass Screening
• Obesity
• ROC Curve
• Sensitivity and Specificity
• diagnosis
• hsrmtgs

Other ID:

• HTX/96714953

UI: 102215925

From Meeting Abstracts