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Sensitivity and specificity of three diabetes diagnostic criteria in people with non-alcoholic fatty liver disease (NAFLD) and otherwise healthy people: Analysis of NHANES III.

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dc.contributor.author Carrillo-Larco, Rodrigo M.
dc.contributor.author Guzman Vilca, Wilmer Cristobal
dc.contributor.author Alvizuri-Gómez, Claudia
dc.contributor.author Tamim, Hani
dc.contributor.author Alqahtani, Saleh A.
dc.contributor.author García-Larsen, Vanessa
dc.date.accessioned 2023-07-18T16:18:55Z
dc.date.available 2023-07-18T16:18:55Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13912
dc.description.abstract AIMS: Establishing whether fasting plasma glucose (FPG), postprandial glucose (PPG), and HbA1c have the same diagnostic accuracy in NAFLD versus otherwise healthy people could inform T2DM screening recommendations for those with NAFLD. METHODS: Cross-sectional analysis of the Third National Health and Nutrition Examination Survey (NHANES III) 1989-1994. T2DM was defined as PPG ≥ 200 mg/dL, FPG ≥ 126 mg/dL, or HbA1c ≥ 6.5 %. We estimated sensitivity and specificity between the six pairwise combinations between the three T2DM definitions in people with and without NAFLD. With Poisson regressions, we investigated if people with NAFLD were more likely to have T2DM with two diagnostic criteria yet not with the third one. RESULTS: There were 3652 people with mean age 55.6 years and 49.4 % were men; 673 (18.4 %) people had NAFLD. Compared to NAFLD-free individuals, those with NAFLD had lower specificity in all pairwise comparisons except when PPG was the reference vs HbA1c [98.28 % (95 % CI: 97.73 %-98.72 %) in people without NAFLD vs 96.15 % (95 % CI: 94.28 %-97.54 %)]. The sensitivity of FPG was slightly superior to PPG and HbA1c in people without NAFLD; for example, 64.62 % (95 % CI: 55.75 %-72.80 %) for FPG vs 56.58 % (95 % CI: 44.71 %-67.92 %) for HbA1c. People with NAFLD were more likely to be diagnosed with FPG and PPG yet not with HbA1c (PR=2.15; p = 0.020). CONCLUSIONS: While these T2DM diagnostic criteria may capture different patients both in people with and without NAFLD, in the NAFLD population FPG appears to have the best sensitivity and there were no differences between PPG and HbA1c in terms of specificity. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Primary Care Diabetes
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject NAFLD en_US
dc.subject Cardiometabolic diseases en_US
dc.subject Screening en_US
dc.subject Diagnostic test en_US
dc.subject Sensitivity en_US
dc.subject Specificity en_US
dc.subject Type 2 diabetes mellitus en_US
dc.subject.mesh Enfermedad del Hígado Graso no Alcohólico
dc.subject.mesh Síndrome Metabólico
dc.subject.mesh Tamizaje Masivo
dc.subject.mesh Pruebas Diagnósticas de Rutina
dc.subject.mesh Sensibilidad y Especificidad
dc.subject.mesh Diabetes Mellitus Tipo 2
dc.title Sensitivity and specificity of three diabetes diagnostic criteria in people with non-alcoholic fatty liver disease (NAFLD) and otherwise healthy people: Analysis of NHANES III. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.pcd.2023.06.003
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 1878-0210


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