Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes
Objective: There are currently five widely used definition of prediabetes. We compared the ability of these to predict 5-year conversion to diabetes and investigated whether there were other cut-points identifying risk of progression to diabetes that may be more useful. Research design and metho...
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| Format: | Journal Article |
| Language: | English |
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BMJ PUBLISHING GROUP
2019
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1103242 http://hdl.handle.net/20.500.11937/94250 |
| _version_ | 1848765853251665920 |
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| author | Lee, Crystal Colagiuri, S. Woodward, M. Gregg, E.W. Adams, R. Azizi, F. Gabriel, R. Gill, T.K. Gonzalez, C. Hodge, A. Jacobs, D.R. Joseph, J.J. Khalili, D. Magliano, D.J. Mehlig, K. Milne, R. Mishra, G. Mongraw-Chaffin, M. Pasco, J.A. Sakurai, M. Schreiner, P.J. Selvin, E. Shaw, J.E. Wittert, G. Yatsuya, H. Huxley, Rachel |
| author_facet | Lee, Crystal Colagiuri, S. Woodward, M. Gregg, E.W. Adams, R. Azizi, F. Gabriel, R. Gill, T.K. Gonzalez, C. Hodge, A. Jacobs, D.R. Joseph, J.J. Khalili, D. Magliano, D.J. Mehlig, K. Milne, R. Mishra, G. Mongraw-Chaffin, M. Pasco, J.A. Sakurai, M. Schreiner, P.J. Selvin, E. Shaw, J.E. Wittert, G. Yatsuya, H. Huxley, Rachel |
| author_sort | Lee, Crystal |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: There are currently five widely used definition of prediabetes. We compared the ability of these to predict 5-year conversion to diabetes and investigated whether there were other cut-points identifying risk of progression to diabetes that may be more useful.
Research design and methods: We conducted an individual participant meta-analysis using longitudinal data included in the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox regression models were used to obtain study-specific HRs for incident diabetes associated with each prediabetes definition. Harrell's C-statistics were used to estimate how well each prediabetes definition discriminated 5-year risk of diabetes. Spline and receiver operating characteristic curve (ROC) analyses were used to identify alternative cut-points.
Results: Sixteen studies, with 76 513 participants and 8208 incident diabetes cases, were available. Compared with normoglycemia, current prediabetes definitions were associated with four to eight times higher diabetes risk (HRs (95% CIs): 3.78 (3.11 to 4.60) to 8.36 (4.88 to 14.33)) and all definitions discriminated 5-year diabetes risk with good accuracy (C-statistics 0.79-0.81). Cut-points identified through spline analysis were fasting plasma glucose (FPG) 5.1 mmol/L and glycated hemoglobin (HbA1c) 5.0% (31 mmol/mol) and cut-points identified through ROC analysis were FPG 5.6 mmol/L, 2-hour postload glucose 7.0 mmol/L and HbA1c 5.6% (38 mmol/mol).
Conclusions: In terms of identifying individuals at greatest risk of developing diabetes within 5 years, using prediabetes definitions that have lower values produced non-significant gain. Therefore, deciding which definition to use will ultimately depend on the goal for identifying individuals at risk of diabetes. |
| first_indexed | 2025-11-14T11:41:51Z |
| format | Journal Article |
| id | curtin-20.500.11937-94250 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:41:51Z |
| publishDate | 2019 |
| publisher | BMJ PUBLISHING GROUP |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-942502024-02-06T05:38:15Z Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes Lee, Crystal Colagiuri, S. Woodward, M. Gregg, E.W. Adams, R. Azizi, F. Gabriel, R. Gill, T.K. Gonzalez, C. Hodge, A. Jacobs, D.R. Joseph, J.J. Khalili, D. Magliano, D.J. Mehlig, K. Milne, R. Mishra, G. Mongraw-Chaffin, M. Pasco, J.A. Sakurai, M. Schreiner, P.J. Selvin, E. Shaw, J.E. Wittert, G. Yatsuya, H. Huxley, Rachel Science & Technology Life Sciences & Biomedicine Endocrinology & Metabolism IMPAIRED FASTING GLUCOSE CARDIOVASCULAR-DISEASE PLASMA-GLUCOSE LIFE-STYLE TYPE-2 TOLERANCE JAPANESE MORTALITY CRITERIA HBA(1C) fasting blood glucose glycated hemoglobin incidence pre-diabetes Biomarkers Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Disease Progression Humans Incidence Prediabetic State Prognosis Risk Factors Humans Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Prediabetic State Disease Progression Prognosis Incidence Risk Factors Biomarkers Objective: There are currently five widely used definition of prediabetes. We compared the ability of these to predict 5-year conversion to diabetes and investigated whether there were other cut-points identifying risk of progression to diabetes that may be more useful. Research design and methods: We conducted an individual participant meta-analysis using longitudinal data included in the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox regression models were used to obtain study-specific HRs for incident diabetes associated with each prediabetes definition. Harrell's C-statistics were used to estimate how well each prediabetes definition discriminated 5-year risk of diabetes. Spline and receiver operating characteristic curve (ROC) analyses were used to identify alternative cut-points. Results: Sixteen studies, with 76 513 participants and 8208 incident diabetes cases, were available. Compared with normoglycemia, current prediabetes definitions were associated with four to eight times higher diabetes risk (HRs (95% CIs): 3.78 (3.11 to 4.60) to 8.36 (4.88 to 14.33)) and all definitions discriminated 5-year diabetes risk with good accuracy (C-statistics 0.79-0.81). Cut-points identified through spline analysis were fasting plasma glucose (FPG) 5.1 mmol/L and glycated hemoglobin (HbA1c) 5.0% (31 mmol/mol) and cut-points identified through ROC analysis were FPG 5.6 mmol/L, 2-hour postload glucose 7.0 mmol/L and HbA1c 5.6% (38 mmol/mol). Conclusions: In terms of identifying individuals at greatest risk of developing diabetes within 5 years, using prediabetes definitions that have lower values produced non-significant gain. Therefore, deciding which definition to use will ultimately depend on the goal for identifying individuals at risk of diabetes. 2019 Journal Article http://hdl.handle.net/20.500.11937/94250 10.1136/bmjdrc-2019-000794 English http://purl.org/au-research/grants/nhmrc/1103242 http://creativecommons.org/licenses/by/4.0/ BMJ PUBLISHING GROUP fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Endocrinology & Metabolism IMPAIRED FASTING GLUCOSE CARDIOVASCULAR-DISEASE PLASMA-GLUCOSE LIFE-STYLE TYPE-2 TOLERANCE JAPANESE MORTALITY CRITERIA HBA(1C) fasting blood glucose glycated hemoglobin incidence pre-diabetes Biomarkers Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Disease Progression Humans Incidence Prediabetic State Prognosis Risk Factors Humans Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Prediabetic State Disease Progression Prognosis Incidence Risk Factors Biomarkers Lee, Crystal Colagiuri, S. Woodward, M. Gregg, E.W. Adams, R. Azizi, F. Gabriel, R. Gill, T.K. Gonzalez, C. Hodge, A. Jacobs, D.R. Joseph, J.J. Khalili, D. Magliano, D.J. Mehlig, K. Milne, R. Mishra, G. Mongraw-Chaffin, M. Pasco, J.A. Sakurai, M. Schreiner, P.J. Selvin, E. Shaw, J.E. Wittert, G. Yatsuya, H. Huxley, Rachel Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| title | Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| title_full | Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| title_fullStr | Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| title_full_unstemmed | Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| title_short | Comparing different definitions of prediabetes with subsequent risk of diabetes: An individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| title_sort | comparing different definitions of prediabetes with subsequent risk of diabetes: an individual participant data meta-analysis involving 76 513 individuals and 8208 cases of incident diabetes |
| topic | Science & Technology Life Sciences & Biomedicine Endocrinology & Metabolism IMPAIRED FASTING GLUCOSE CARDIOVASCULAR-DISEASE PLASMA-GLUCOSE LIFE-STYLE TYPE-2 TOLERANCE JAPANESE MORTALITY CRITERIA HBA(1C) fasting blood glucose glycated hemoglobin incidence pre-diabetes Biomarkers Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Disease Progression Humans Incidence Prediabetic State Prognosis Risk Factors Humans Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Prediabetic State Disease Progression Prognosis Incidence Risk Factors Biomarkers |
| url | http://purl.org/au-research/grants/nhmrc/1103242 http://hdl.handle.net/20.500.11937/94250 |