Analysis and evaluation of the diagnosis criteria of World Health Organization and American Diabetes Association for diabetes mellitus in senile population / 中华内分泌代谢杂志

ABSTRACT

Objective To evaluate the sensitivity and the specificity of WHO and American Diabetes Association (ADA) diagnosis criteria for diabetes mellitus (DM) in senile population and to assess the use of fasting plasma glucose (FPG) alone for the screening of DM as defined by a 2 hour plasma glucose (2hPG)≥11.1 mmol/L during oral 75 g glucose tolerance test (OGTT) and to determine optimal FPG cut point for DM diagnosis. Methods One thousand two hundred and four subjects without DM aged 60 to 90 year, who had resided in Beijing for over 5 years, were recruited, and grouped into different glucose levels by WHO or ADA criteria and analyzed the concordance and the discordance between these subpopulations. The WHO criterion for DM (2hPG≥11.1 mmol/L) was taken as the gold standard. The variations of sensitivity and specificity on ADA criterion for DM (FPG≥7.0 mmol/L) were assessed and determined the optimal FPG cut point in the seniles. Results The prevalence of DM was 3.16% and 16.28% by ADA (FPG) criterion and WHO(2hPG) criterion respectively. The sensitivity of diagnosed DM was 15.3% and the specificity was 99.2% according to ADA criterion. The coincidence percentage under the two criteria was only 15.3%. The coincidence percentage under impaired fasting blood glucose (IFG) and impaired glucose tolerance (IGT) was only 4.5%. The optimal FPG cut point of diagnosed DM was 5.5 mmol/L in the seniles, which was affected by gender, age, body mass index and the presence of hypertension. Conclusion There is lack of concordance between WHO and ADA criteria for DM diagnosis in the seniles. The ADA IFG criterion is not able to replace WHO criterion for DM diagnosis. The senile people with FPG≥5.5 mmol/L but