Snap diagnosis of fulminant type 1 diabetes by the normalized glucose/HbA1c ratio

IF 1.3 4区医学 Q4 ENDOCRINOLOGY & METABOLISM Endocrine journal Pub Date : 2024-08-10 DOI:10.1507/endocrj.ej24-0226

Jun-Ichiro Mori, Takahiro Miyakoshi, Hanae Yuzuriha, Teruki Kondo, Eita Nishimori, Motoji Naka, Ai Sato, Mitsuhisa Komatsu, Koh Yamashita, Toru Aizawa

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Abstract

Elevated Fulminant Index (FI), [plasma glucose (PG)/glycosylated hemoglobin A1c (HbA1c)], was reportedly a sensitive index to differentiate fulminant type 1 diabetes (FT1D) from non-fulminant T1D (nFT1D). Aim of this study was to describe a better, but simpler index of FT1D. 49 and 52 patients with FT1D and nFT1D, respectively, were registered, and the discriminating ability of the rounded, normalized ratio, [PG (mmol/L) – 5.0]/[HbA1c (%) – 5.0], and the original ratio, [PG (mmol/L)]/[HbA1c (%)], was compared. Normalizing the ratio significantly raised its accuracy: area under the curve for receiver operating curve, AUROC (95%CI), 0.927 (0.858–0.964) and 0.851 (0.763–0.910), respectively, with and without the normalization (p < 0.01). Rounding of the figure into [PG (mmol/L) – 5.0]/[HbA1c (%) – 5.0] did not significantly sacrifice the discriminating ability of the index. Namely, the optimal cut point of rounded and normalized GAR, 10.0, showed 89.8% sensitivity. In conclusion, rounded, normalized (rn) GAR ≥10 (the rounded optimal cut-off) could be used for the snap diagnosis of FT1D.

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通过正常化血糖/HbA1c 比值快速诊断暴发性 1 型糖尿病

据报道，升高的暴发性指数（FI）[血浆葡萄糖（PG）/糖基化血红蛋白 A1c（HbA1c）]是区分暴发性 1 型糖尿病（FT1D）和非暴发性 1 型糖尿病（nFT1D）的敏感指数。本研究旨在描述一种更好但更简单的 FT1D 指标。研究分别登记了 49 名和 52 名 FT1D 和 nFT1D 患者，并比较了四舍五入后的正常化比值[PG（mmol/L）-5.0]/[HbA1c（%）-5.0]和原始比值[PG（mmol/L）]/[HbA1c（%）]的鉴别能力。对比率进行归一化处理可明显提高其准确性：进行和未进行归一化处理的接收者操作曲线下面积 AUROC（95%CI）分别为 0.927（0.858-0.964）和 0.851（0.763-0.910）（p <0.01）。将数字四舍五入为[PG（mmol/L）-5.0]/[HbA1c（%）-5.0]并不会明显影响指数的判别能力。也就是说，四舍五入和归一化 GAR 的最佳切点（10.0）显示了 89.8% 的灵敏度。总之，四舍五入归一化（rn）GAR ≥10（四舍五入最佳切点）可用于快速诊断 FT1D。

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来源期刊

Endocrine journal 医学-内分泌学与代谢

CiteScore

4.30

自引率

5.00%

发文量

224

审稿时长

1.5 months

期刊介绍： Endocrine Journal is an open access, peer-reviewed online journal with a long history. This journal publishes peer-reviewed research articles in multifaceted fields of basic, translational and clinical endocrinology. Endocrine Journal provides a chance to exchange your ideas, concepts and scientific observations in any area of recent endocrinology. Manuscripts may be submitted as Original Articles, Notes, Rapid Communications or Review Articles. We have a rapid reviewing and editorial decision system and pay a special attention to our quick, truly scientific and frequently-citable publication. Please go through the link for author guideline.