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Titolo:
SERUM FRUCTOSAMINE AS A SCREENING-TEST FOR DIABETES IN THE ELDERLY - A PILOT-STUDY
Autore:
CEFALU WT; ETTINGER WH; BELLFARROW AD; RUSHING JT;
Indirizzi:
WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT INTERNAL MED,ENDOCRINOL METAB SECT,MED CTR BLVD WINSTON SALEM NC 27157 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI WINSTON SALEMNC 27157
Titolo Testata:
Journal of the American Geriatrics Society
fascicolo: 10, volume: 41, anno: 1993,
pagine: 1090 - 1094
SICI:
0002-8614(1993)41:10<1090:SFAASF>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMPAIRED GLUCOSE-TOLERANCE; GLYCOSYLATED HEMOGLOBIN; PLASMA-GLUCOSE; MELLITUS; ASSAY; DIAGNOSIS; PROTEIN; INDEX; ALBUMIN; GLYCOHEMOGLOBIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social Sciences Citation Index
Science Citation Index Expanded
Citazioni:
45
Recensione:
Indirizzi per estratti:
Citazione:
W.T. Cefalu et al., "SERUM FRUCTOSAMINE AS A SCREENING-TEST FOR DIABETES IN THE ELDERLY - A PILOT-STUDY", Journal of the American Geriatrics Society, 41(10), 1993, pp. 1090-1094

Abstract

Objective: To determine the value of serum glycated protein, measuredas serum fructosamine, as a screening test for diabetes in the elderly. Design: Cross-sectional pilot study. Setting: Ambulatory research clinic in university setting. Patients: One hundred fifty-seven consecutive community-dwelling participants in the Cardiovascular Health Study, average age 71.8 + 5 (mean +/- SD, range 65-88 years). Measurements: Serum fructosamine levels (first and second generation assay) were obtained. All subjects who did not have a diagnosis of diabetes were given a 75-g glucose tolerance test (GTT). Results: Twenty-six subjects (17%) (10 previously diagnosed, 16 undiagnosed and asymptomatic) had diabetes mellitus, and 38 subjects (24%) had impaired glucose toleranceby history or by the GTT (WHO criteria). Only the 16 asymptomatic diabetics were included in the analysis for the pilot study. There was a significant difference in the fasting fructosamine level between non-diabetics and asymptomatic diabetics for the first generation (2.06 +/-.21 vs 2.53 +/- .49 mMol/L, P < 0.0015) and second generation assay (221 +/- 27 vs 269 +/- 48 muMol/L, P < 0.0012). Receiver operator curves were constructed to evaluate the test characteristics of serum fructosamine. Using a point of greater-than-or-equal-to 2.3 mMol/L for the first-generation assay, the sensitivity to detect asymptomatic diabetes was 75%, specificity 83%, and positive predictive value 35%. To detect both diabetes and impaired glucose tolerance using a cutpoint of greater-than-or-equal-to 2.3 mMol/L, the sensitivity was 24%, specificity 95%, and positive predictive value 68%. Employing a cut point of 250muMol/L for the second generation assay, the sensitivity to detect diabetes was 81%, specificity 87%, and positive predictive value 43%. However, to detect diabetes and glucose intolerance using the second generation assay, the sensitivity was 39% and specificity was 86%. Conclusion: This study demonstrated that a single measurement of either first or second generation fructosamine showed promise as a screening testfor diabetes, but not impaired glucose tolerance, in older people.

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Documento generato il 24/11/20 alle ore 13:02:52