Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort
Abstract We investigated whether adding anthropometric measures to HbA1c would have stronger discriminative ability over HbA1c alone in detecting dysglycemia (diabetes and prediabetes) among Asian women trying to conceive. Among 971 Singaporean women, multiple regression models and area under receiv...
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Nature Portfolio
2020
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oai:doaj.org-article:8fa5d7e53b5c4646be05135981dec54a2021-12-02T17:52:24ZAnthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort10.1038/s41598-020-66147-x2045-2322https://doaj.org/article/8fa5d7e53b5c4646be05135981dec54a2020-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-66147-xhttps://doaj.org/toc/2045-2322Abstract We investigated whether adding anthropometric measures to HbA1c would have stronger discriminative ability over HbA1c alone in detecting dysglycemia (diabetes and prediabetes) among Asian women trying to conceive. Among 971 Singaporean women, multiple regression models and area under receiver-operating characteristic (AUROC) curves were used to analyze associations of anthropometric (weight, height, waist/hip circumferences, 4-site skinfold thicknesses) and HbA1c z-scores with dysglycemia (fasting glucose ≥6.1 mmol/L with 2-hour glucose ≥7.8 mmol/l). The prevalence of dysglycemia was 10.9%. After adjusting for sociodemographic/medical history, BMI (Odds Ratio [OR] = 1.62 [95%CI 1.32–1.99]), waist-to-height ratio (OR = 1.74 [1.39–2.17]) and total skinfolds (OR = 2.02 [1.60–2.55]) showed the strongest associations with dysglycemia but none outperformed HbA1c (OR = 4.09 [2.81–5.94]). After adjustment for history, adding BMI, waist-to-height ratio and total skinfolds (anthropometry trio) as continuous variables to HbA1c (AUROC = 0.80 [95%CI 0.75–0.85]) performed similarly to HbA1c alone (AUROC = 0.79 [0.74–0.84]). However, using clinically-defined thresholds without considering history, as in common clinical practice, BMI ≥ 23 kg/m2 + HbA1c ≥ 5.7% (AUROC = 0.70 [0.64–0.75]) and anthropometry trio + HbA1c ≥ 5.7% (AUROC = 0.71 [0.65–0.76]) both outperformed HbA1c ≥ 5.7% alone (AUROC = 0.61 [0.57–0.65]). In a two-stage strategy, incorporating BMI ≥ 23 kg/m2 alongside HbA1c ≥ 5.7% into first-stage screening to identify high risk women for subsequent oral glucose tolerance testing improves dysglycemia detection in Asian women preconception.Anne H. Y. ChuIzzuddin M. ArisSharon NgSee Ling LoyJonathan Y BernardMya Thway TintWen Lun YuanKeith M. GodfreyJerry Kok Yen ChanLynette Pei-Chi ShekYap Seng ChongKok Hian TanSeng Bin AngHeng Hao TanBernard S. M. ChernFabian YapYung Seng LeeNgee LekMelvin Khee-Shing LeowChin Meng KhooShiao-Yng ChanNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-10 (2020) |
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Medicine R Science Q Anne H. Y. Chu Izzuddin M. Aris Sharon Ng See Ling Loy Jonathan Y Bernard Mya Thway Tint Wen Lun Yuan Keith M. Godfrey Jerry Kok Yen Chan Lynette Pei-Chi Shek Yap Seng Chong Kok Hian Tan Seng Bin Ang Heng Hao Tan Bernard S. M. Chern Fabian Yap Yung Seng Lee Ngee Lek Melvin Khee-Shing Leow Chin Meng Khoo Shiao-Yng Chan Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort |
| description |
Abstract We investigated whether adding anthropometric measures to HbA1c would have stronger discriminative ability over HbA1c alone in detecting dysglycemia (diabetes and prediabetes) among Asian women trying to conceive. Among 971 Singaporean women, multiple regression models and area under receiver-operating characteristic (AUROC) curves were used to analyze associations of anthropometric (weight, height, waist/hip circumferences, 4-site skinfold thicknesses) and HbA1c z-scores with dysglycemia (fasting glucose ≥6.1 mmol/L with 2-hour glucose ≥7.8 mmol/l). The prevalence of dysglycemia was 10.9%. After adjusting for sociodemographic/medical history, BMI (Odds Ratio [OR] = 1.62 [95%CI 1.32–1.99]), waist-to-height ratio (OR = 1.74 [1.39–2.17]) and total skinfolds (OR = 2.02 [1.60–2.55]) showed the strongest associations with dysglycemia but none outperformed HbA1c (OR = 4.09 [2.81–5.94]). After adjustment for history, adding BMI, waist-to-height ratio and total skinfolds (anthropometry trio) as continuous variables to HbA1c (AUROC = 0.80 [95%CI 0.75–0.85]) performed similarly to HbA1c alone (AUROC = 0.79 [0.74–0.84]). However, using clinically-defined thresholds without considering history, as in common clinical practice, BMI ≥ 23 kg/m2 + HbA1c ≥ 5.7% (AUROC = 0.70 [0.64–0.75]) and anthropometry trio + HbA1c ≥ 5.7% (AUROC = 0.71 [0.65–0.76]) both outperformed HbA1c ≥ 5.7% alone (AUROC = 0.61 [0.57–0.65]). In a two-stage strategy, incorporating BMI ≥ 23 kg/m2 alongside HbA1c ≥ 5.7% into first-stage screening to identify high risk women for subsequent oral glucose tolerance testing improves dysglycemia detection in Asian women preconception. |
| format |
article |
| author |
Anne H. Y. Chu Izzuddin M. Aris Sharon Ng See Ling Loy Jonathan Y Bernard Mya Thway Tint Wen Lun Yuan Keith M. Godfrey Jerry Kok Yen Chan Lynette Pei-Chi Shek Yap Seng Chong Kok Hian Tan Seng Bin Ang Heng Hao Tan Bernard S. M. Chern Fabian Yap Yung Seng Lee Ngee Lek Melvin Khee-Shing Leow Chin Meng Khoo Shiao-Yng Chan |
| author_facet |
Anne H. Y. Chu Izzuddin M. Aris Sharon Ng See Ling Loy Jonathan Y Bernard Mya Thway Tint Wen Lun Yuan Keith M. Godfrey Jerry Kok Yen Chan Lynette Pei-Chi Shek Yap Seng Chong Kok Hian Tan Seng Bin Ang Heng Hao Tan Bernard S. M. Chern Fabian Yap Yung Seng Lee Ngee Lek Melvin Khee-Shing Leow Chin Meng Khoo Shiao-Yng Chan |
| author_sort |
Anne H. Y. Chu |
| title |
Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort |
| title_short |
Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort |
| title_full |
Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort |
| title_fullStr |
Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort |
| title_full_unstemmed |
Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort |
| title_sort |
anthropometric measures and hba1c to detect dysglycemia in young asian women planning conception: the s-presto cohort |
| publisher |
Nature Portfolio |
| publishDate |
2020 |
| url |
https://doaj.org/article/8fa5d7e53b5c4646be05135981dec54a |
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