Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception : the S-PRESTO cohort
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-operat...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2021
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| Online Access: | https://hdl.handle.net/10356/146119 |
| _version_ | 1811686754217885696 |
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| author | Chu, Anne H. Y. Aris, Izzuddin M. Ng, Sharon Loy, See Ling Bernard, Jonathan Y. Tint, Mya Thway Yuan, Wen Lun Godfrey, Keith M. Chan, Jerry Kok Yen Shek, Lynette Pei-Chi Chong, Yap Seng Tan, Kok Hian Ang, Seng Bin Tan, Heng Hao Chern, Bernard S. M. Yap, Fabian Lee, Yung Seng Lek, Ngee Leow, Melvin Khee-Shing Khoo, Chin Meng Chan, Shiao-Yng |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Chu, Anne H. Y. Aris, Izzuddin M. Ng, Sharon Loy, See Ling Bernard, Jonathan Y. Tint, Mya Thway Yuan, Wen Lun Godfrey, Keith M. Chan, Jerry Kok Yen Shek, Lynette Pei-Chi Chong, Yap Seng Tan, Kok Hian Ang, Seng Bin Tan, Heng Hao Chern, Bernard S. M. Yap, Fabian Lee, Yung Seng Lek, Ngee Leow, Melvin Khee-Shing Khoo, Chin Meng Chan, Shiao-Yng |
| author_sort | Chu, Anne H. Y. |
| collection | NTU |
| description | 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. |
| first_indexed | 2024-10-01T05:05:26Z |
| format | Journal Article |
| id | ntu-10356/146119 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T05:05:26Z |
| publishDate | 2021 |
| record_format | dspace |
| spelling | ntu-10356/1461192023-03-05T16:48:02Z Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception : the S-PRESTO cohort Chu, Anne H. Y. Aris, Izzuddin M. Ng, Sharon Loy, See Ling Bernard, Jonathan Y. Tint, Mya Thway Yuan, Wen Lun Godfrey, Keith M. Chan, Jerry Kok Yen Shek, Lynette Pei-Chi Chong, Yap Seng Tan, Kok Hian Ang, Seng Bin Tan, Heng Hao Chern, Bernard S. M. Yap, Fabian Lee, Yung Seng Lek, Ngee Leow, Melvin Khee-Shing Khoo, Chin Meng Chan, Shiao-Yng Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Diagnostic Markers Endocrine System and Metabolic Diseases 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. Agency for Science, Technology and Research (A*STAR) Ministry of Health (MOH) National Medical Research Council (NMRC) National Research Foundation (NRF) Published version The S-PRESTO study group includes Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Bee Wah Lee, Bobby Cheon, Christiani Jeyakumar Henry, Ciaran Gerard Forde, Claudia Chi, Doris Fok, Elaine Quah, Elizabeth Tham, Evelyn Chung Ning Law, Evelyn Xiu Ling Loo, Faidon Magkos, Falk Mueller-Riemenschneider, George Seow Heong Yeo, Helen Yu Chen, Hugo P S van Bever, Joanne Yoong, Joao N. Ferreira., Jonathan Tze Liang Choo, Kenneth Kwek, Kuan Jin Lee, Lieng Hsi Ling, Ling Wei Chen, Lourdes Mary Daniel, Marielle V. Fortier, Mary Foong-Fong Chong, Mei Chien Chua, Michael Meaney, Neerja Karnani, Oon Hoe Teoh, Queenie Ling Jun Li, Sendhil Velan, Shephali Tagore, Shirong Cai, Shu E Soh, Sok Bee Lim, Stella Tsotsi, Stephen Chin-Ying Hsu, Sue Anne Toh, Teng Hong Tan, Tong Wei Yew, Victor Samuel Rajadurai, Wee Meng Han, Wei Wei Pang, Yin Bun Cheung, and Yiong Huak Chan. We also acknowledge the efforts of the research coordinators, admin staff, study managers and participants. This work was supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore - NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. 2021-01-27T01:58:17Z 2021-01-27T01:58:17Z 2020 Journal Article Chu, A. H. Y., Aris, I. M., Ng, S., Loy, S. L., Bernard, J. Y., Tint, M. T., . . . Chan, S.-Y. (2020). Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception : the S-PRESTO cohort. Scientific Reports, 10(1), 9228-. doi:10.1038/s41598-020-66147-x 2045-2322 https://hdl.handle.net/10356/146119 10.1038/s41598-020-66147-x 32514017 2-s2.0-85086163562 1 10 en NMRC/TCR/004-NUS/2008 NMRC/TCR/012-NUHS/2014 Scientific Reports © 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. application/pdf |
| spellingShingle | Science::Medicine Diagnostic Markers Endocrine System and Metabolic Diseases Chu, Anne H. Y. Aris, Izzuddin M. Ng, Sharon Loy, See Ling Bernard, Jonathan Y. Tint, Mya Thway Yuan, Wen Lun Godfrey, Keith M. Chan, Jerry Kok Yen Shek, Lynette Pei-Chi Chong, Yap Seng Tan, Kok Hian Ang, Seng Bin Tan, Heng Hao Chern, Bernard S. M. Yap, Fabian Lee, Yung Seng Lek, Ngee Leow, Melvin Khee-Shing Khoo, Chin Meng Chan, Shiao-Yng Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception : the S-PRESTO cohort |
| title | 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_short | 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 |
| topic | Science::Medicine Diagnostic Markers Endocrine System and Metabolic Diseases |
| url | https://hdl.handle.net/10356/146119 |
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