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- Title
Combined Use of Fasting Plasma Glucose, BMI and Hypertension Is a Good Predictor to Detect Early Stage of Impaired Glucose Tolerance and Diabetes in Resident of Rural Area in Japanese Population (Tottori-Kofu Study).
- Authors
Ohkura, Tsuyoshi; Taniguchi, Shin-Ichi; Inoue, Kazuoki; Norimoto, Tomoka; Kinoshita, Hiroshi; Baba, Hiroo; Takechi, Mikio; Shigemasa, Chiaki
- Abstract
In Japan, government-driven screening for IGT and diabetes is only FPG≥110mg/dl. This is not enough to detect IGT of Japanese, because the etiology of diabetes in Japanese is not high FPG due to insulin resistance and obesity but high postprandial glucose due to an intrinsic lower insulin response, reported by DECODA study. In this study, we aimed to find out the effective way to detect IGT in Japanese based on limited information derived from government-driven screening data, by simple and cost benefit method. In 66th ADA scientific sessions, we reported that 75g-OGTT was applied to 207 participants with FPG≥100mg/dl, or with FPG< 100 and having any other following criteria, HbA[sub 1C]≥5.5%, BMI≥25kg/m², TG>150mg/dl and undergoing hypertension treatment (HT) in 2005, to detect early stage of IGT and to prevent the atheroselerosis in "Kofu town" near University, where prevalence of apoplexy is three times higher than average of Japanese population. The prevalence of IGT and diabetes was about 80% in participants with 100≤FPG< 110, and with FPG<100 and HbA[sub 1C]≥5.5%, and in FPG<100 and HbA[sub 1C]<5.5%, 13% with high TG, 27% with high BMI, 39% with HT. We tried to make the new criteria to derive 50% abnormal subjects from high FPG and HbA[sub 1C] group. Then, we converted the sampling criteria to the followings. We conducted medical examination of 1033 inhabitants, OGTT was applied to 250 participants with FPG≥95mg/dl, or with FPG<95 and having any other following criteria, HbA[sub 1C] 5.3%, BMI≥25 kg/m², TG≥150 mg/dl, and HT in 2006. IGT and diabetes was 81 patients (32%) in 250 high risk participants. The prevalence of IGT and diabetes was 68% in participants with 100≤FPG<110, and 28% with 95≤FPG<100. In participants with FPG<95, the prevalence was only 25% in subjects with HbA[sub 1C]≥5.3%, 0% with high TG, 33% with high BMI, 33% with HT. These results indicate that the combination of HT and BMI is more effective predictor to detect IGT and DM rather than the limited use of FPG and HbA[sub 1c]. We speculate that combined use of FPG≥100mg/dl and BMI≥25 kg/m² and FIT is a good predictor to detect early stage of IGT and diabetes in Japanese population. In respect of the high prevalence of HT in Japanese population (40%), our new criteria including HT is very important to develop the sensitive and cost-benefit method to detect IGT in Japanese or other asian population.
- Subjects
JAPAN; DIAGNOSIS of diabetes; BLOOD sugar; BODY mass index; HYPERTENSION; HEALTH status indicators; JAPANESE people; RURAL health; DISEASES
- Publication
Diabetes, 2007, Vol 56, pA651
- ISSN
0012-1797
- Publication type
Article