Research On Cut-off Point In 0.5 Hour Postprandial Blood Glucose For Early Screening Of Diabetes Mellitus

Objectives The aim of this study was to explore the optimal cut-off point for early screening of diabetes using 0.5 hour postprandial blood glucose with an oral glucose tolerance test.Methods In this study,OGTT2 h plasma glucose(PG2h)?11.1mmol/L was used as the gold standard for diagnosing diabetes in the Diagnostic Criteria for Diabetes,revised by the World Health Organization(WHO)in 1999.Diabetes and non-diabetic groups were selected based on this standard.From January in 2008 to January in 2018,the population of OGTT examination in the first time among outpatients,inpatients,and healthy examiners at North China University of Science and Technology affiliated Kailuan General Hospital in Tangshan city,was object as the study.Among them:PG2h?11.1mmol/L was as the diabetic group,PG2h<11.1mmol/L was as non-diabetic control group.The above research subjects met the entry and exclusion criteria of the test.Then collect and collate the data.0.5 hours postprandial blood glucose was measured with hexokinase method.Statistical analysis of all data used SPSS19.0 software.First analyzed the factors affecting the PG0.5h,determined the relationship between PG0.5h and diabetes,and calculated the P value and OR value through the?~2 test;then using the area of the ROC curve determined whether the 0.5 hour postprandial blood glucose screening diabetes had clinical value,selected the screening cut-off point according to the Youden index,to evaluate the sensitivity and specificity of the cut-off point and related blood glucose value;finally determined the optimal cut-off point for early screening of diabetes in PG0.5h.Results 1 Age ratio between the diabetic group and the non-diabetic group.The results showed that there was no statistically significant difference between the two groups(P>0.05).2 Gender ratio between the diabetic group and the non-diabetic group.The results showed that there was no statistically significant difference between the two groups(P>0.05).3 Analysis of the effect of gender on 0.5 hour postprandial blood glucose.The results showed that there was no correlation between gender and PG0.5h,and the difference was no statistically significant(P>0.05).4 Analysis of the effect of age on 0.5hour postprandial blood glucose.The results showed that there was a correlation between age and PG0.5h,and the difference was statistically significant(P<0.05).5 Analysis of the effect of 2 hours postprandial blood glucose on 0.5 hour postprandial blood glucose.The results showed that there was a correlation between PG2 h and PG0.5h,the average level of PG0.5h in diabetes group was higher than that in non-diabetic group,and the difference was statistically significant(P<0.05).6 Analysis of the relationship between 0.5 hour postprandial blood glucose and diabetes with the groups based on the average level of PG0.5h,?12.24mmol/L as the exposure group,<12.24mmol/L as non-exposure.The results showed that there was a statistically significant difference in the number of exposure groups between the diabetic group and non-diabetes group with an OR of 23.14,the 95%confidence interval of 19.31~27.72.7 Drawing the ROC curve of PG0.5h in the25~59 age group with PG2h?11.1mmol/L as the gold standard for diagnosing diabetes mellitus.The results showed that the area under the ROC curve of PG0.5h screening for diabetes was 0.915(95%confidence interval:0.907~0.923,P<0.05).When the PG0.5h=10.57mmol/L,the Youden index was 64.5%,the sensitivity was 87.5%,and the specificity was 77.0%.At this time,the sensitivity and specificity were both high,and the?value was 0.64.It is indicated that PG0.5h can be used for early screening of diabetes in25~59 years old.8 Drawing the ROC curve of PG0.5h in the 60~74 age group with PG2h?11.1mmol/L as the gold standard for diagnosing diabetes mellitus.The results showed that the area under the ROC curve of PG0.5h screening for diabetes was 0.885(95%confidence interval is:0.869~0.900,P<0.05).When the PG0.5h=10.48mmol/L,the Youden index was 59.6%,the sensitivity was 86.4%,and the specificity was 73.2%.At this time,the sensitivity and specificity were both high,and the?value was 0.60.It is indicated that PG0.5h also can be used for early screening of diabetes in 60~74 years old.Conclusions The cut-off point for early screening for diabetes at 0.5 hours postprandial blood glucose was 10.57 mmol/L in the 25~59 years old group and 10.48 mmol/L in the60~74 years old group.