OBJECTIVE To examine whether the 1-h blood glucose measurement would be a more suitable screening tool for assessing the risk of diabetes and its complications than the 2-h measurement. RESEARCH DESIGN AND METHODS We conducted a prospective population-based cohort study of 4,867 men, randomly selected from prespecified birth cohorts between 1921 and 1949, who underwent an oral glucose tolerance test with blood glucose measurements at 0, 1, and 2 h. Subjects were followed for up to 39 years, with registry-based recording of events. Discriminative abilities of elevated 1-h (≥8.6 mmol/L) versus 2-h (≥7.8 mmol/L) glucose for predicting incident type 2 diabetes, vascular complications, and mortality were compared using Kaplan-Meier analysis, Cox proportional hazards regression, and net reclassification improvement. RESULTS Median age was 48 years (interquartile range [IQR] 48-49). During follow-up (median 33 years [IQR 24-37]), 636 (13%) developed type 2 diabetes. Elevated 1-h glucose was associated with incident diabetes (hazard ratio 3.40 [95% CI 2.90-3.98], P < 0.001) and provided better risk assessment than impaired glucose tolerance (Harrell concordance index 0.637 vs. 0.511, P < 0.001). Addition of a 1-h measurement in subjects stratified by fasting glucose provided greater net reclassification improvement than the addition of a 2-h measurement (0.214 vs. 0.016, respectively). Finally, the 1-h glucose was significantly associated with vascular complications and mortality. CONCLUSIONS The 1-h blood glucose level is a stronger predictor of future type 2 diabetes than the 2-h level and is associated with diabetes complications and mortality.

中文翻译：

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1小时口服葡萄糖耐量试验的增强预测能力：一项基于人群的前瞻性队列研究。

目的要检查1小时血糖测量是否比2小时测量更适合用于评估糖尿病风险及其并发症的筛查工具。研究设计和方法我们进行了一项基于人群的前瞻性队列研究，该队列研究从1921年至1949年之间从预先指定的出生队列中随机选择的4867名男性进行了口服葡萄糖耐量测试，并分别于0、1、2 h进行了血糖测量。对受试者进行长达39年的随访，并记录了基于注册表的事件。使用Kaplan-Meier分析，Cox比例风险回归比较了升高的1 h（≥8.6mmol / L）与2 h（≥7.8mmol / L）葡萄糖对预测2型糖尿病，血管并发症和死亡率的判别能力。 ，并改善了净重分类。结果中位年龄为48岁（四分位间距[IQR] 48-49）。在随访中（中位33岁[IQR 24-37]），有636名（13％）患上了2型糖尿病。1 h血糖升高与糖尿病的发生有关（危险比3.40 [95％CI 2.90-3.98]，P <0.001），并且比糖耐量下降提供了更好的风险评估（Harrell一致性指数0.637 vs. 0.511，P <0.001）。与添加2小时测量值相比，在空腹血糖分层的受试者中添加1小时测量值可提供更大的净重分类改善（分别为0.214和0.016）。最后，1-h葡萄糖与血管并发症和死亡率显着相关。结论1小时血糖水平比2小时血糖水平更能预测未来2型糖尿病，并且与糖尿病并发症和死亡率相关。