COMPARISON OF GLUCOSE-TOLERANCE CATEGORIES ACCORDING TO WORLD-HEALTH-ORGANIZATION AND AMERICAN-DIABETES-ASSOCIATION DIAGNOSTIC-CRITERIA IN A POPULATION-BASED STUDY IN BRAZIL

OBJECTIVE - To compare the prevalence of different categories of gluco se tolerance in a Japanese-Brazilian population using World Health Org anization (WHO) and American Diabetes Association (ADA) diagnostic cri teria. RESEARCH DESIGN AND METHODS - The analyses were based on the da ta obtained from a study conducted in a representative sample of the J apanese-Brazilian population composed of 647 subjects (40-79 years) wh o were submitted to a 2-h oral glucose tolerance test. Prevalence of g lucose tolerance categories and the level of agreement (kappa statisti cs) were obtained using WHO and ADA criteria. Cardiovascular risk prof ile of the subjects with different diagnostic categories were compared . RESULTS - Similar prevalences of diabetes were found considering bot h criteria (WHO, 20.3%; ADA, 19.2%). The prevalence of impaired glucos e tolerance (IGT) by WHO criteria was 14.7%, contrasting with 7.4% of impaired fasting glucose (IFG) by ADA criteria. Subjects with discorda nt diagnostic categories by the criteria, considered at risk for diabe tes (IGT/IFG), showed a worse metabolic profile than the concordant no rmal subjects. However, subjects with discordant diagnoses who had IGT or diabetes by WHO criteria but who were normal by ADA criteria exhib ited a higher number of cardiovascular risk factors (higher blood pres sure and triglyceride and low HDL cholesterol) than those who were dis cordant (IFG/diabetes) by ADA criteria but normal by WHO criteria. CON CLUSIONS - Although the number of diabetic subjects was similar betwee n the criteria, those identified as being at risk for diabetes were qu ite distinct. Fewer subjects were classified as having IFG by ADA crit eria than as having IGT by WHO criteria. Abnormal glucose tolerance ba sed on WHO criteria seems to identify a worse cardiovascular profile t han abnormal tolerance based on ADA criteria. Follow-up studies are ne cessary to know the prognostic significance of IFG to predict subseque nt diabetes.