Performance of Fasting Plasma Glucose and Postprandial Urine Glucose in Screening for Diabetes in Chinese High-risk Population.

BACKGROUND: The conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population. METHODS: Nine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A1c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis. RESULTS: Among 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P < 0.001). For estimation of 2 h-PG ≥ 7.8 mmol/L and 2 h-PG ≥ 11.1 mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI ]: 0.738-0.806) and 0.885 (95% CI: 0.850-0.921), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 mmol/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity for detecting glucose abnormalities (84.1% vs. 73.7%, P < 0.001) and diabetes (82.7% vs. 48.1%, P < 0.001). CONCLUSION: FPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.

[Value of serum advanced glycation end products-peptide in the screening of diabetes mellitus in a community-based population of high-risk diabetics].

OBJECTIVE: To explore the value of serum advanced glycation end products-peptide (AGE-P) in the screening of diabetes mellitus in a community-based population of high-risk diabetics. METHODS: A total number of 857 adult high-risk diabetics from a community-based population underwent 75 g oral glucose tolerance test (OGTT). Blood samples were drawn to measure the levels of fasting blood glucose (FBG), postprandial blood glucose (2 hPG) and glycosylated hemoglobin A1c (HbA1c). And blood samples were also collected to determine the serum level of AGE-P with the technique of flow injection analysis. Receiver operating characteristic (ROC) curve was plotted to assess the screening value of serum AGE-P in diabetes mellitus. Pearson correlation analysis was conducted to evaluate the association between serum AGE-P and FBG, 2 hPG, HbA1c, body mass index (BMI), waist-to-hip ratio (WHR) and age. RESULTS: Among them, 218 adults were diagnosed with diabetes based on the 2010 American Diabetes Association (ADA) criteria. According to the ROC curve, the optimal cut-point of serum AGE-P for diagnosing diabetes was 10.22 mg/L (a peak height of 25.39 mm) with sensitivity of 84.1%, specificity of 88.3% and positive predictive value of 71%. The area under curve (AUC) of serum AGE-P, FBG, 2 hPG and HbA1c for diagnosing diabetes was 0.924, 0.905, 0.951 and 0.874 respectively. When comparing AUC between serum AGE-P and HbA1c, FBG and 2 hPG, statistical significance was only found in the comparisons between serum AGE-P and HbA1c (P<0.025). Pearson correlation analysis showed that serum AGE-P was highly positively correlated with HbA1c, significantly positively correlated with FBG and 2 hPG and slightly positively correlated with WHR and age (all P<0.05). But there was no correlation with BMI. CONCLUSIONS: Serum AGE-P may be used for the screening of diabetes in the community-based population of high-risk diabetics. And it is even superior to HbA1c.