medigraphic.com

2017, Number 2

<< Back Next >>

Rev Cuba Endoc 2017; 28 (2)

Evaluation of three methodologies for risk prediction of impaired glucose metabolism in overweighed and obese subjects

Cabrera RE, Rodríguez CV, Rodríguez J, Cubas DI, Álvarez ÁA, Arnold DY, Díaz DO

Language: Spanish
References: 54
Page: 1-19
PDF size: 196.43 Kb.


ABSTRACT

Introduction: at present, there is no set strategy in Cuba for the screening of impaired glucose metabolism.
Objective: to evaluate the diagnostic capacity of three methodologies to predict the risk of impaired glucose metabolism in overweighed and obese individuals.
Methods: a longitudinal diagnostic evaluation study was carried out using data from 90 subjects aged 25 to 70 years, which were analyzed two and a half years after the initial assessment. Information about age, sex, personal pathological history, used medication, weight, height, waist circumference and blood pressure as well the glucose concentrations at the beginning and two and a half years later, insulin and triglyceride indexes was collected in addition to estimating the insulinresistance index in the initial evaluation. A risk-score model for type 2 diabetes was also used.
Results: the frequency of impaired glucose metabolism (impaired fasting glycemia and type 2 diabetes) after two and a half years, according to the previous existence or not of impaired fasting glycemia, insulin resistance and moderate/high risk of type 2 diabetes, was higher in subjects with previous impaired fasting glycemia (72,4 % [21/29]), with insulin resistance at the beginning (65.6 % [40/61]) and with moderate/high risk (54,4 % [43/79]) than in those individuals without impaired fasting glycemia, insulin resistance and with low diabetes risk (41.0 % [25/61], p= 0,005; 20.7 % [6/29], p= 0.006 and 27.3 % [3/11], p< 0.0001, respectively). Insulin resistance index and moderate/high risk of type 2 diabetes showed high sensitivity to identify subjects with impaired glucose metabolism (87.0 and 93.5 %, respectively), in contrast to impaired fasting glucose whose sensitivity was low (45.7 %). Of 19 individuals who developed type 2 diabetes two and a half years later, 100 % had moderate/high risk of type 2 diabetes and 94.7 % had insulin resistance at the beginning.
Conclusions: insulin resistance and risk of type 2 diabetes could be very useful in detecting individuals with high risk of developing diabetes.


REFERENCES

  1. Arnold Y, Licea M, Aldana D. Algunos aspectos relevantes de la epidemiología de la diabetes mellitus en Cuba. Rev Peruana Epidemiol. 2011;15(3):1609-7211.

  2. IDF Diabetes Atlas [homepage en Internet]; IDF, 2015 [citado 6 de abril de 2017]. Disponible en: http://www.diabetesatlas.org/

  3. ALAD. Guías ALAD sobre diagnóstico, control y tratamiento de la Diabetes Tipo 2 con medicina basada en evidencia [homepage en Internet]; edición 2013, Revista ALAD 2013 [citado 11 de noviembre de 2013]. Disponible en: http://issuu.com/alad-diabetes/docs/guias_alad_2013

  4. Cuba. Ministerio de Salud Pública (Minsap). Anuario Estadístico de Salud 2012 [homepage en Internet]; 2012 [citado 29 de diciembre de 2013]. Disponible en: http://files.sld.cu/dne/files/2013/04/anuario_2012.pdf

  5. Cuba. Ministerio de Salud Pública (Minsap). Anuario Estadístico de Salud 2015 [homepage en Internet]; 2015 [citado 21 de septiembre de 2016]. Disponible en: http://files.sld.cu/dne/files/2016/04/Anuario_2015_electronico-1.pdf

  6. Cuba. Ministerio de Salud Pública (Minsap). Proyecciones de la salud pública en Cuba para el 2015. La Habana: MINSAP; 2006. p. 35-6.

  7. Grupo de Trabajo sobre Diabetes y Enfermedades Cardiovasculares de la Sociedad Europea de Cardiología (ESC) y de la Sociedad Europea para el Estudio de la Diabetes (EASD). Guías de práctica clínica sobre diabetes, prediabetes y enfermedades cardiovasculares: versión resumida. Rev Esp Cardiol. 2007;60(5):525.e1-e64.

  8. American Diabetes Association. Standards of Medical Care in Diabetes-2017. Diabetes Care. 2017;40(sup 1):S1-S135.

  9. Díaz O, Cabrera E, Orlandi N, Araña M, Díaz O. Aspectos epidemiológicos de la prediabetes, diagnóstico y clasificación. Rev Cubana Endocrinol. 2011;22(1):3-10.

  10. Rosas J, Calles J, Friege F, Lara A, Suverza A, Campuzano R, et al. Consenso de Prediabetes. Documento de Posición de la Asociación Latinoamericana de Diabetes (ALAD). Rev ALAD. 2009;17(4):146-58.

  11. Calderín RO, Monteagudo G, Yanes MA, García J, Marichal S, Cabrera E, et al. Síndrome metabólico y prediabetes. Rev Cubana Endocrinol. 2011;22(1):52-7.

  12. García de los Ríos MA, Durrutya P. Prevención de la diabetes mellitus tipo 2. Rev Med Clin Condes. 2009;20(5):580-7.

  13. Pereira O L. Diabesidad: una epidemia del siglo XXI. Medisan. 2012;16(2):295-8

  14. Lindström J, Tuomilehto J. The diabetes risk score. A practical tool predicts type 2 diabetes risk. Diabetes Care. 2003;26(3):725-31.

  15. Tuomilehto J, Lindström J, Hellmich M, Lehmacher W, Westermeiere T, Evers T, et al. Development and validation of a risk-score model for subjects with impaired glucose tolerance for the assessment of the risk of type 2 diabetes mellitus-The STOP-NIDDM risk-score. Diab Res Clin Pract. 2010;87(2):267-74.

  16. Pottie K, Jaramillo A, Lewin G, Dickinson J, Bell N, Brauer P, et al. Canadian Task Force on Preventive Health Care. Recommendations on screening for type 2 diabetes in adults. CMAJ. 2012;184(15):1687-96.

  17. Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, et al. A risk score for predicting incident diabetes in the Thai population. Diab Care. 2006;29(8):1872-7.

  18. Rathmann W, Martin S, Haastert B, Icks A, Holle R, Lowel H, et al. Performance of screening questionnaires and risk scores for undiagnosed diabetes: the KORA Survey 2000. Arch Intern Med. 2005;165(4):436-41.

  19. Schulze M, Hoffmann K, Boeing H, Linseisen J, Rohrmann S, Möhlig M, et al. An accurate risk score based on anthropometric, dietary and lifestyle factors to predict the development of type 2 diabetes. Diab Care. 2007;30(3):510-5.

  20. Hippiisley J, Coupland C, Robson J, Sheikh A, Brindle P. Predicting risk of type 2 diabetes in England and Whales: prospective derivation and validation. BMJ. 2009;10:273-82.

  21. Gray LJ, Taub NA, Khunti K, Gardiner E, Hiles S, Webb DR, et al. The Leicester Risk Assessment score for detecting undiagnosed type 2 diabetes and impaired glucose regulation for use in a multi-ethnic UK setting. Diabet Med. 2010;27(8):887-95.

  22. Soriguer F, Valdés S, Tapia MJ, Esteva I, Ruiz de Adana MS, Cruz Almaraz M, et al. Validación del FINDRISC (Finnish Diabetes Risk Score) para la predicción del riesgo de diabetes tipo 2 en una población del sur de España. Estudio Pizarra. Med Clin (Barc). 2012;138(9):371-6.

  23. Jølle A, Midthjell K, Holmen J, Tuomilehto J, Carlsen SM, Shaw J, et al. Impact of sex and age on the performance of FINDRISC: the HUNT Study in Norway. BMJ Open Diabetes Research and Care. 2016;4:e000217.

  24. Salinero-Fort MA, Burgos-Lunar C, Lahoz C, Mostaza JM, Abánades-Herranz JC, Laguna-Cuesta F, et al. Performance of the Finnish Diabetes Risk Score and a Simplified Finnish Diabetes Risk Score in a Community-Based, Cross-Sectional Programme for Screening of Undiagnosed Type 2 Diabetes Mellitus and Dysglycaemia in Madrid, Spain: The SPREDIA-2 Study. PLoS ONE. 2016;11(7):e0158489.

  25. Lindström J, Peltonen M, Ericksson JG, Aunola S, Hämäläinen H, Ilianne-Parikka P, et al. Determinants for the effectiveness of lifestyle intervention in the Finnish diabetes prevention study. Diabetes Care. 2008;31:857-62.

  26. Lee CM, Colagiuri S. Risk scores for diabetes prediction: the International Diabetes Federation PREDICT-2 project. Diabetes Res Clin Pract. 2013;100(2):285-6.

  27. Tankova T, Chakarova N, Atanassova I, Dakovska L. Evaluation of the Finnish Diabetes Risk Score as a screening tool for impaired fasting glucose, impaired glucose tolerance and undetected diabetes. Diabetes Res Clin Pract. 2011;92(1):46-52.

  28. Mathews DR, Hosker JP, Rudenki AS, Nailor BA, Treacher DF, Turner RC. Homeostasis model assessment: Insulin resistance and beta cell function from fasting plasma glucose and insulin concentration in man. Diabetologia. 1985;28(7):412-9.

  29. Arranz C, González RM, Álvarez A, Rodríguez B, Reyes A. Criterios de referencia para los indicadores de secreción de insulina y de los parámetros lipídicos en una población mixta hospitalaria. Rev Cubana Endocrinol. 2010;21(1):1-12.

  30. Riobó P. Obesity and diabetes. Nutr Hosp. 2013;28(sup 5):138-43.

  31. Tabák AG, Herder C, Rathmann W, Brunner EJ. Prediabetes: A high-risk state for developing diabetes. Lancet. 2012;379(9833):2279-90.

  32. Al Amiri E, Abdullatif M, Abdulle A, AL Bitar N, Zaki Afandi E, Parish M, et al. The prevalence, risk factors, and screening measure for prediabetes and diabetes among Emirati overweight/obese children and adolescents. BMC Public Health. 2015;15:1298.

  33. Reaven G. Insulin Resistance and Coronary Heart Disease in Nondiabetic Individuals. Arterioscler Thromb Vasc Biol. 2012;32:1754-9.

  34. Chen X, Su M, Wang C, Wu Z, Li S, Ying X, et al. Role of insulin resistance and β cell function in the development of newly diagnosed type 2 diabetes. Wei Sheng Yan Jiu. 2015 Nov;44(6):881-6.

  35. Perich P, González RM, Valdés E, Arranz MC. Desarrollo de diabetes mellitus en pacientes con tolerancia a la glucosa alterada. Seguimiento de 18 años. Rev Cubana Endocrinol [serie en Internet]. 2002 [citado 15 de febrero de 2017];13(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532002000200002&lng=es

  36. Bermúdez S, Buchaca E, Suárez del Villar Y, Rodríguez L, Alonso CA, Mansur M, et al. Trastornos de la glucemia y de la acción de la insulina en una población de riesgo de diabetes. Rev Cubana Endocrinol. 2009;20(3):120-30.

  37. González RM, Perich P, Arranz C. Trastornos metabólicos asociados con la evolución hacia la diabetes mellitus tipo 2 en una población en riesgo. Rev Cubana Endocrinol. 2010;21(2):110-25.

  38. Bustillo Solano EE, Bustillo Madrigal EE, Pérez Y, Pérez R, Brito A, González A, et al. Prevalencia de la diabetes mellitus y de la glucemia alterada en ayunas en un área de la ciudad de Sancti Spíritus. Rev Cubana Endocrinol. 2013;24(2):107-24.

  39. Edwards CM, Cusi K. Prediabetes. A Worldwide Epidemic. Endocrinol Metab Clin N Am. 2016;45:751-64.

  40. Inoue K, Inoue M, Matsumoto M, Akimoto K. Persistent fasting hyperglycaemia is more predictive of type 2 diabetes than transient fasting hyperglycaemia. Diab Med. 2012;29:e75-81.

  41. Neelan J, Turer T, Ayers R, Powell-Wiley TM, Vega GL, Farzaneh-Far R, et al. Dysfuntional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA. 2012;308(11):1150-9.

  42. Sang R, Jeong W. The prediabetic period: Review of clinical aspects. Diab Metab J. 2011;35:107-16.

  43. Ja J, Seung K, Hyuk K, Nan K, Jae K, Chul K, et al. Prevalence of diabetes and prediabetes according to fasting plasma glucose and HbA1c. Diab Metab J. 2013;37:349-57.

  44. DeFronzo RA, Tripathy D, Schwenke DC, Banergi MA, Bray GA, Buchanan TA, et al. Prediction of diabetes based on baseline metabolic characteristics in individuals at high risk. Diabetes Care. 2013;36:3607-12.

  45. Bergman M. Pathophysiology of prediabetes and treatment implications for the prevention of type 2 diabetes mellitus. Endocrine. 2013;43:504-13.

  46. Tabak AG, Jokela M, Akbaraly TN, Brunner EJ, Kivimäki M, Witte DR. Trajectories of glycemia, insulin sensitivity and insulin secretion preceding the diagnosis of type 2 diabetes: The Whitehall II Study. Lancet. 2009;373(9682):2215-21.

  47. de Lima CLJ, de Olivera PS, Costa Ferreira TM, da Silva EC, Lopes Ferreira JD, de Andrade RS, et al. Risk factors for type II diabetes mellitus: an integrative review. Int Arch Med. 2016;9(308):1-11.

  48. Lyssenko V, Almgren P, Anevski D, Perfekt R, Lahti K, Nissén M, et al. Predictors of and longitudinal changes in insulin sensitivity and secretion preceding onset of type 2 diabetes. Diabetes. 2005;54:166-74.

  49. Morrison KM, Xu L, Tarnopolsky M, Yusuf Z, Atkinson SA, Yusuf S. Screening for dysglycemia in overweight young presenting for weight management. Diabetes Care. 2012;35:711-6.

  50. Noble D, Mathur R, Dent T, Meads C, Greenhalgh T. Risk models and scores for type 2 diabetes: systematic review. BMJ [serie en Internet]. 2011 [citado 6 de abril de 2017];343:d7163. Disponible en: http://www.bmj.com/content/bmj/343/bmj.d7163.full.pdf

  51. Atabek ME, Pirgon O. Assessment of insulin sensitivity from measurements in fasting state and during an oral glucose tolerance test in obese children. J Pediatr Endocrinol Metab. 2007;20(2):187-95.

  52. Colagiuri S. Epidemiology of prediabetes. Med Clin N Am. 2011;95:299-307.

  53. Fernández R, Arranz C, Ortega JA, Hernández J. Resistencia a la insulina y cambios metabólicos en adultos obesos. Rev Cubana Endocrinol. 2011;22(2):78-90.

  54. Soares Lima AC, Moura Araújo MF, Júnior Freire de Freitas RW, Zanetti ML, César de Almeida P, Coelho Damasceno MM. Factores de riesgo para diabetes mellitus tipo 2 en universitarios: asociación con variables sociodemográficas. Rev Latino-Am Enfermagem. 2014;22(3):484-90.




2020     |     www.medigraphic.com