OGTT and random plasma glucose in the prediction of type 1 diabetes and time to diagnosis

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• 作者：Olli Helminen ; Susanna Aspholm ; Tytti Pokka ; Jorma Ilonen ; Olli Simell…
• 关键词：Children ; Dysglycaemia ; Islet autoimmunity ; OGTT ; Plasma glucose ; Type 1 diabetes
• 刊名：Diabetologia
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：58
• 期：8
• 页码：1787-1796
• 全文大小：284 KB
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  4.Ziegler AG, Rewers M, Simell O et al (2013) Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children. JAMA 309:2473-479PubMed View Article
  5.Siljander HT, Hermann R, Hekkala A et al (2013) Insulin secretion and sensitivity in the prediction of type 1 diabetes in children with advanced beta-cell autoimmunity. Eur J Endocrinol 169:479-85PubMed View Article
  6.Sosenko JM, Skyler JS, Herold KC, Palmer JP, Type 1 Diabetes TrialNet and Diabetes Prevention Trial–Type 1 Study Groups (2012) The metabolic progression to type 1 diabetes as indicated by serial oral glucose tolerance testing in the Diabetes Prevention Trial–Type 1. Diabetes 61:1331-337PubMed Central PubMed View Article
  7.Sosenko JM, Skyler JS, Mahon J et al (2012) The application of the Diabetes Prevention Trial–Type 1 Risk Score for identifying a preclinical state of type 1 diabetes. Diabetes Care 35:1552-555PubMed Central PubMed View Article
  8.Ferrannini E, Mari A, Nofrate V, Sosenko JM, Skyler JS, DPT-1 Study Group (2010) Progression to diabetes in relatives of type 1 diabetic patients: mechanisms and mode of onset. Diabetes 59:679-85PubMed Central PubMed View Article
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  10.Helminen O, Aspholm S, Pokka T et al (2015) HbA1c predicts time to diagnosis of type 1 diabetes in children at risk. Diabetes 64:1719-727
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  18.Hekkala A, Ilonen J, Knip M, Veijola R, Finnish Paediatric Diabetes Register (2011) Family history of diabetes and distribution of class II HLA genotypes in children with newly diagnosed type 1 diabetes: effect on diabetic ketoacidosis. Eur J Endocrinol 165:813-17PubMed View Article
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• 作者单位：Olli Helminen (1)
  Susanna Aspholm (2)
  Tytti Pokka (1)
  Jorma Ilonen (3) (4)
  Olli Simell (5)
  Riitta Veijola (1)
  Mikael Knip (2) (6) (7) (8)
  
  1. Department of Pediatrics, PEDEGO Research Group, Medical Research Center, Oulu University Hospital and University of Oulu, PO Box 5000, FIN-90014, Oulu, Finland
  2. Tampere Centre for Child Health Research, Tampere University Hospital, Tampere, Finland
  3. Immunogenetics Laboratory, University of Turku, Turku, Finland
  4. Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
  5. Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
  6. Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  7. Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
  8. Folkh?lsan Research Center, Helsinki, Finland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Internal Medicine
  Metabolic Diseases
  Human Physiology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0428

文摘

Aims/hypothesis We assessed the utility of the OGTT and random plasma glucose concentrations in predicting the time to diagnosis of type 1 diabetes. Methods A population-derived cohort of 14,876 newborns with HLA-conferred risk of type 1 diabetes were invited to regular follow-up for islet autoantibodies. When two or more autoantibodies were detected, an OGTT was performed once a year and random plasma glucose analysed twice a year. During follow-up, 567 children developed multiple autoantibodies, 255 (45%) of whom were diagnosed with type 1 diabetes, while 312 remained non-diabetic by December 2011. Results Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were risk factors for type 1 diabetes (HR 3.2 [95% CI 1.5, 7.0] and 8.3 [95% CI 6.0, 11.5], respectively). When a random plasma glucose value ?.8?mmol/l was observed, the HR for diabetes was 6.0 (95% CI 4.3, 8.6). The median time to diagnosis after the detection of IFG was 5.2?years (interquartile range [IQR] 3.4, 6.3); after IGT, 0.7?years (IQR 0.3, 1.9); and, after a random plasma glucose ?.8?mmol/l, 1.0?years (IQR 0.3, 1.5). In a retrospective analysis, both OGTT-derived 2?h plasma glucose and random plasma glucose started to increase 1.5?years before diagnosis (p-lt;-.001 and p--.004, respectively). Conclusions/interpretation Dysglycaemia detected in an OGTT or based on random plasma glucose is a useful marker in the prediction of time to onset of type 1 diabetes in high-risk children. Random plasma glucose is a simple and low-cost measurement with comparable predictive characteristics to that of OGTT-derived 2?h glucose.