The Dysglycemia Risk Score And Markers Of Workers In Dagang Oil Field

Objective: To screen the risk factors of dysglycemia and develop a dysglycemia risk score in working-age population at Dagang oilfield.Further,to screen out diabetes markers from plasminogen activator inhibitor-1(PAI-1),hepatocyte growth factor(HGF),and Glucagon like peptide-1(GLP-1),together with dysglycemia risk score to provide clues for early prevention of diabetes.Method:We screened the increased risk population through cluster sampling by the modified Finnish diabetes risk score(m-FINDRISC)questionnaire in populations of attending annual physical examination at oil fild.Oral glucose tolerance test(OGTT)was administed to those increased risk population on another agreed date.The increased risk populations were divided into normal glucose tolerance group(NGT)and dysglycemia group according to OGTT.The risk factors of dysglycemia were identified by multivariate logistic regression based on epidemiology,anthropometry and biochemical index from questionnaire and examination results.We developed Dagang dysglycemia risk(Dagang DRS)by regression coefficient.The performance of Dagang DRS between m-FINDRISC and FPG value model were compared through the area under receiver operating characteristic(ROC)curve area(AUC).We extracted increased risk population on a certain period of time as the objects,grouped into NGT,impaired glucose regulation(IGR),diabetes mellitus(DM).The concentration of PAI-1,HGF,GLP-1 and GIP among three groups were tested by ELISA method.Multiple cumulative logistic regression model was used to analyze the risk of incident IGR or incident DM.The possible diabetes markers were identified by comparing with the risks of FPG.Outcomes: The present study included a total of 1995 working age(20-64 years)population,of which female 1,010(50.6%),dysglycemia 776(38.9%),DM 226(11.3%)and the fasting blood glucose(FPG)less than 6.1mmol/L 1,545(77.4%).sex,smoking,age,history of high blood glucose,and BMI,FPG,and TG were the risk factors of increased risk population in the working age population in Dagang oil field.The totle score of Dagang DRS incorporating seven risks described as the above was 55 points.The diagnostic performance of Dagang DRS is better than m-FINDRISC(AUC: 0.791;95% confidence interval(CI),0.773-0.809 vs.0.633;95% CI,0.611-0.654)(P,<0.001)in all participants,but poor to tha of FPG value(AUC: 0.820,95% CI,0.802-0.836)(P=0.0003).However,The diagnostic performance of Dagang DRS was superior to that of simple FPG value in those with FPG<6.1mmol/L(AUC: 0.616;95% CI,0.592-0.641 vs.0.571;95% CI,0.546-0.596)(n=1545,P =0.028).The optimal cut-off point value of Dagang DRS was 19 points in all participants with the sensitivity,specificity,positive and negative likelihood ratio being 0.736(95% CI,0.703-0.76),0.735(95% CI,0.709-0.760),2.78(95% CI,2.50-3.10),0.36(95% CI,0.30-0.40),respectively and 11 points in populations with FPG<6.1mmol/L with corresponding sensitivity,specificity,positive and negative likelihood ratio being 0.647(95% CI,0.593-0.699),0.555(95% CI,0.527-0.584),1.46(95% CI,1.30-1.60),0.64(95% CI,0.50-0.70)respectively.A total of 139 samples(2014.8-2014.10)were selected as objects,of which female 62(44.6%),NGT 36(25.9%),impaired glucose regulation(IGR)55(39.6%),DM 48(34.5%).When PAI-1>69.83 ng/ml,the risk of the incident IGR or the incident DM increased by 6.08 times(OR:6.08 95%CI 2.52-14.70)compared with NGT,and 4.07(OR: 95%CI 1.45-11.40)times for HGF>0.36 ng/ml.Additional 1mmo/L of FPG led to 6.84(OR: 6.84,95%CI 3.73-12.55)fold increase of the risk of the incident IGR or the incident DM.Conclusion: Dagang DRS is valuable for predicting dysglycemia in working-age populations at Dagang oil field,especially for the population with FPG<6.1mmol/L.PAI-1 and HGF can be both used as markers of diabetes.Dagang DRS combined with diabetes markers is not only beneficial to early prevention of prediabetes,but also conducive to much earlier detection and intervention of prediabetes.