Predictive value of first fasting plasma glucose compared with admission plasma glucose for undiagnosed diabetes in a stable cardiology population

• Published in: Clinical biochemistry 2012-09, Vol.45 (13-14), p.1057-1063
• Main Authors: Wen, Zhu-zhi, Zhang, Xin-mei, Mai, Zun, Geng, Deng-feng, Wang, Jing-feng
• Format: Article
• Language: English
• Subjects: Admission plasma glucose; Adult; Aged; Aged, 80 and over; Area Under Curve; Biological and medical sciences; Blood Glucose - analysis; C-Reactive Protein - analysis; Cardiology; Cardiovascular Diseases - diagnosis; Databases, Factual; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting - blood; Fasting - metabolism; Fasting plasma glucose; Female; Glucose - analysis; Glucose - metabolism; Glucose Tolerance Test; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Oral glucose tolerance test; Physical Examination; Predictive Value of Tests; Prevalence; Reproducibility of Results; ROC Curve; Sensitivity and Specificity; Young Adult
• ISSN: 0009-9120; 1873-2933
• DOI: 10.1016/j.clinbiochem.2012.05.020

The study compared the predictive value of admission plasma glucose (APG) and first fasting plasma glucose (FPG) in stratifying patients meriting an oral glucose tolerance test (OGTT). Characteristics of APG, FPG and OGTT 2-hour glucose as well as other blood measurements, physical examinations and medical information were assessed in 994 patients without known diabetes. The prevalences of diabetes and impaired glucose tolerance were 24.6% and 37.9%, according to an OGTT, respectively. The first FPG demonstrated stronger predictive value in diagnosing diabetes than APG did both in overall and in patients with less clinical value. Compared to the first FPG, APG provided less value to coronary artery disease, hypertension and high-sensitivity C-reactive protein for diabetes screening. The first FPG exerted more predictive value than APG did and was still a preferable reference prior to APG in stratifying patients for undiagnosed diabetes by an OGTT. ► New-onset diabetes is common in cardiology population without known diabetes. ► Fasting glucose has a stronger correlation with postchallenge glucose than admission glucose does. ► Fasting glucose is better than admission glucose in predicting unknown diabetes. ► Fasting glucose is preferable to admission glucose in stratify patients for OGTTs.