Clinical Importance of One-Hour Plasma Glucose in Relation to Diabetes and Metabolic Syndrome in an Obese Population

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is increasingly prevalent and associated with increased morbi/mortality. In Caucasian obese subjects we investigated a possible link between 1-hour plasma glucose (1HrPG), diabetes and the metabolic syndrome (MetS). Methods: Overweight and obese patients were consecutively included from the obesity clinic. ROC-curves were used to compare the diagnostic sensitivity and specificity of 1HrPG vs. fasting plasma glucose (FPG), 2HrPG, and HbA1c to diagnose diabetes, using American Diabetes Association criteria. Results: We included 2439 patients (72% female) [mean age 43±13 years, median BMI 37.3 (33.7-41.3) kg/m²]. Diabetes was diagnosed in 9.8% and prediabetes in 33.8% of subjects. Exactly 1262 (51,7%) had a 1HrPG ≥155 mg/dL. These subjects were more insulin-resistant (p<0.001), had a higher waist (p<0.001), visceral adipose tissue (VAT) (p<0.001), systolic blood pressure (p<0.001), worse lipid profile (p<0.001), and higher plasminogen activator inhibitor-1 (PAI-1) [p<0.001] than subjects with 1HrPG <155mg/dL. MetS was present in 64.1% of the subjects with 1HrPG ≥155 mg/dL vs. 42.5% of subjects with a 1HrPG <155 mg/dL (p<0.001). In the group with 1HrPG ≥155 mg/dL only 32.6% had a normal glucose tolerance (NGT) while 18.5% was diagnosed with T2DM and 48.9% had prediabetes, compared to 81.7% NGT, 0.6% T2DM and 17.7% prediabetes in subjects with a 1HrPG < 155 mg/dL (p<0.001). In the group with NGT 412 subjects (30,0%) had a 1HrPG ≥155 mg/dL. These subjects showed higher HOMA-IR (p=0.008), VAT (p<0.001), blood pressure (p<0.001), worse lipid profile (p=0.001) than those with a 1HrPG<155 mg/dl, indicating its clinical relevance. For diabetes, the ROC area under the curve for 2HrPG was 0.928, compared to 1HrPG (0.764), Hba1c (0.752) and, FPG (0.600). Conclusion: This study supports the need for detection of subjects with higher 1HrPG values. being at risk for development of T2DM, MetS and cardiovascular disease. Disclosure L. Haverals: None. K.P.S. Van Dessel: None. A. Verrijken: None. E.L. Dirinck: None. F.W. Peiffer: None. L. Van Gaal: Advisory Panel; Self; Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Janssen J & J, Merck MSD, Novo Nordisk, Sanofi and Servier/Intarcia. Speaker's Bureau; Self; Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Janssen J & J, Merck MSD, Novo Nordisk, Sanofi and Servier/Intarcia. Research Support; Self; EU (Hepadip & Resolve consortium) and National Research Funds. C. De Block: None.