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Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults

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Abstract

Purpose

Diabetes mellitus (DM) is a global health concern linked to various complications, including cardiovascular disease (CVD). However, long-term follow-up studies on the risk of DM and CVD using different blood glucose assessment methods in the general Korean population are lacking. This study aimed to assess the predictive abilities of fasting plasma glucose (FPG), 2-h oral glucose tolerance test (OGTT), and glycosylated hemoglobin (HbA1c) for new-onset DM and high CVD risk in a middle-aged and older Korean population.

Methods

This study used data from the Korean Genome and Epidemiology Study, a population-based prospective cohort. Blood sugar measures (FPG, OGTT, and HbA1c) were examined. The primary endpoint was the development of new-onset DM, and CVD risk was evaluated using the Framingham risk score. The predictive abilities for new-onset DM based on glycemic values were evaluated using Harrell’s Concordance index and 95% confidence intervals.

Results

Among the 10,030 participants, data of 6813 participants without DM at baseline were analyzed. The study revealed that OGTT outperformed FPG and HbA1c in predicting new-onset DM. The combination of FPG and HbA1c did not significantly enhance predictions for DM compared with OGTT alone. OGTT also outperformed FPG and HbA1c in predicting high CVD risk, and this difference remained significant even after adjusting for additional confounders.

Conclusion

OGTT has superior predictive capabilities in identifying new-onset DM and high CVD risk in the Korean population. This suggests that relying solely on individual blood sugar measures may be insufficient for assessing DM and CVD risks.

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Data availability

The dataset used in this study (Ansan and Ansung cohort) is available from the Korea Centers for Disease Control and Prevention (http://www.cdc.go.kr/CDC/eng/main.jsp) upon request.

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Acknowledgements

We are grateful to the individuals who conducted the Korean Genome and Epidemiology Study as well as the civilians who participated in this study. Epidemiological data used in this study were obtained from the Korean Genome and Epidemiology Study (KoGES; KBP 2016-0730117) of the Korea Centers for Disease Control and Prevention, Republic of Korea.

Funding

This work was supported by the Korea Institute of Planning and Evaluation for Technology in Food, Agriculture and Forestry (IPET) through the High Value-added Food Technology Development Program funded by the Ministry of Agriculture, Food and Rural Affairs (MAFRA).

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Authors and Affiliations

  1. Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea

    Jung-Hwan Kim & Ji-Won Lee

  2. Department of Biostatistics and Computing, Yonsei University, Seoul, 03722, Republic of Korea

    Yaeji Lee

  3. Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, 03722, Republic of Korea

    Chung-Mo Nam

  4. Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, 16995, Republic of Korea

    Yu-Jin Kwon

  5. Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, 03722, Republic of Korea

    Ji-Won Lee

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Contributions

J.H.K., Y.J.K., and J.W.L. formed the study concept and designed the study. J.H.K., Y.J.K., and J.W. L. collected, and interpreted the data. J.H.K. wrote the first draft, revised later drafts of the article. J.H.K., Y.L., and C.M.N. analyzed the data and performed the statistical analysis. Y.J.K., and J.W.L. revised the article. All authors read and approved the final manuscript.

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Correspondence to Yu-Jin Kwon or Ji-Won Lee.

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This study was performed in line with the principles of the Declaration of Helsinki. The study protocol was approved by the Ethics Committee of the Korean Center for Disease Control and the Institutional Review Board of the College of Medicine (approval number: 4-2023-0903).

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Kim, JH., Lee, Y., Nam, CM. et al. Assessing blood sugar measures for predicting new-onset diabetes and cardiovascular disease in community-dwelling adults. Endocrine (2024). https://doi.org/10.1007/s12020-024-03876-3

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