Dysglycemia risk index with objective variables and one-hour glucose tolerance test
Keywords:
diabetes mellitus, type 2; risk factors; blood glucose; glucose tolerance test; ROC curve; sensitivity and specificity; predictive value of testsAbstract
Introduction: When fasting blood glucose is 5.6 mmol/L or higher, it is essential to identify individuals with persistent dysglycemia.
Objective: To validate a dysglycemia risk index based on objective variables and the one-hour oral glucose tolerance test.
Material and Methods: A cross-sectional, analytical, technology assessment study was conducted in three stages. In the first stage, a dysglycemia risk index was constructed using binary logistic regression from 922 patients evaluated with the one-hour oral glucose tolerance test (1-hour OGTT) in Matanzas. In the second stage, internal validation was performed. In the third stage, the index was validated in 1.071 patients from Havana with similar characteristics. The diagnostic value was compared with the ADA risk test using receiver operating characteristic curve, sensitivity, specificity, predictive values, and Youden index.
Results: The index was made up of TyG ≥ 8.3 (five points), BMI ≥ 27 kg/m² (three points), history of high blood pressure (two points), and a first-degree relative with diabetes (two points), with a maximum value of 12 and a cutoff at 8. In both series, it had lower sensitivity than the ADA test, but higher AUC, specificity, positive predictive value, and Youden index, with an excellent negative predictive value that was comparable between both instruments.
Conclusions: The dysglycemia risk index, based on objective variables and the 1-hour OGTT, shows better diagnostic value than the ADA risk test due to its higher specificity and Youden index. It is feasible and useful for optimizing resources in preventive exams.
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