This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (164)  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in JAMA  Social Bookmarking   What's this?

The Hoorn Study

Femmie de Vegt, PhD; Jacqueline M. Dekker, PhD; Agnes Jager, MD,PhD; Ellen Hienkens, MSc; Pieter J. Kostense, PhD; Coen D. A. Stehouwer, MD,PhD; Giel Nijpels, MD,PhD; Lex M. Bouter, PhD; Robert J. Heine, MD,PhD

JAMA. 2001;285:2109-2113.

Context  Persons with impaired glucose tolerance (IGT) are known to have an elevated risk of developing diabetes mellitus. Less is known about diabetes risk among persons with impaired fasting glucose (IFG) or with normal glucose levels.

Objective  To determine the incidence of diabetes in relation to baseline fasting and postload glucose levels and other risk factors.

Design, Setting, and Participants  Population-based cohort study conducted from October 1989 to February 1992 among 1342 nondiabetic white residents of Hoorn, the Netherlands, aged 50 to 75 years at baseline, in whom fasting plasma glucose (FPG) levels and glucose levels 2 hours after a 75-g oral glucose tolerance test were measured at baseline and at follow-up in 1996-1998.

Main Outcome Measures  Cumulative incidence of diabetes, defined according to the diagnostic criteria of the World Health Organization (WHO-1985 and WHO-1999) and the American Diabetes Association (ADA-1997), during a mean follow-up of 6.4 years, compared among participants with IFG, IGT, and normal glucose levels at baseline.

Results  The cumulative incidence of diabetes was 6.1%, 8.3%, and 9.9% according to the WHO-1985, ADA, and WHO-1999 criteria, respectively. The cumulative incidence of diabetes (WHO-1999 criteria) for participants with both IFG and IGT was 64.5% compared with 4.5% for those with normal glucose levels at baseline. The odds ratios for diabetes (WHO-1999 criteria), adjusted for age, sex, and follow-up duration, were 10.0 (95% confidence interval [CI], 6.1-16.5), 10.9 (95% CI, 6.0-19.9), and 39.5 (95% CI, 17.0-92.1), respectively, for those having isolated IFG, isolated IGT, and both IFG and IGT. In addition to FPG and 2-hour postload glucose levels (P<.001 for both), the waist-hip ratio also was an important risk factor for developing diabetes (P = .002).

Conclusion  In this study, the cumulative incidence of diabetes was strongly related to both IFG and IGT at baseline and, in particular, to the combined presence of IFG and IGT.

Author Affiliations: Institute for Research in Extramural Medicine (Drs de Vegt, Dekker, Jager, Kostense, Stehouwer, Nijpels, Bouter, Heine, and Ms Hienkens), Department of Clinical Epidemiology and Biostatistics (Dr Kostense), and Department of Internal Medicine, University Hospital (Drs Stehouwer and Heine), Vrije Universiteit, Amsterdam, the Netherlands; and Department of Epidemiology and Biostatistics, University Medical Centre Nijmegen, Nijmegen, the Netherlands (Dr de Vegt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTER

Use of Growth Hormone in Elderly Individuals
Saul Malozowski
JAMA. 2003;290(4):462.
EXTRACT | FULL TEXT  

RELATED ARTICLE

April 25, 2001
JAMA. 2001;285(16):2141-2142.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Diabetes prevalence and risk factors among ethnic minorities
Ujcic-Voortman et al.
Eur J Public Health 2009;0:ckp096v1-ckp096.
ABSTRACT | FULL TEXT  

Progression to Impaired Glucose Regulation and Diabetes in the Population-Based Inter99 Study
Engberg et al.
Diabetes Care 2009;32:606-611.
ABSTRACT | FULL TEXT  

Relationship of adiposity with arterial stiffness as mediated by adiponectin in older men and women: the Hoorn Study
Snijder et al.
Eur J Endocrinol 2009;160:387-395.
ABSTRACT | FULL TEXT  

Prevalence of Pre-Diabetes and Its Association With Clustering of Cardiometabolic Risk Factors and Hyperinsulinemia Among U.S. Adolescents: National Health and Nutrition Examination Survey 2005-2006
Li et al.
Diabetes Care 2009;32:342-347.
ABSTRACT | FULL TEXT  

The Metabolic Syndrome
Cornier et al.
Endocr. Rev. 2008;29:777-822.
ABSTRACT | FULL TEXT  

Cognitive Impairment: An Increasingly Important Complication of Type 2 Diabetes: The Age, Gene/Environment Susceptibility-Reykjavik Study
Saczynski et al.
Am J Epidemiol 2008;168:1132-1139.
ABSTRACT | FULL TEXT  

American College of Endocrinology Pre-Diabetes Consensus Conference: Part One
Bloomgarden
Diabetes Care 2008;31:2062-2069.
FULL TEXT  

Can Admission and Fasting Glucose Reliably Identify Undiagnosed Diabetes in Patients With Acute Coronary Syndrome?
Okosieme et al.
Diabetes Care 2008;31:1955-1959.
ABSTRACT | FULL TEXT  

Impaired fasting glucose with or without impaired glucose tolerance: progressive or parallel states of prediabetes?
Perreault et al.
Am. J. Physiol. Endocrinol. Metab. 2008;295:E428-E435.
ABSTRACT | FULL TEXT  

Absence of an Acute Insulin Response Predicts Onset of Type 2 Diabetes in a Caucasian Population with Impaired Glucose Tolerance
Nijpels et al.
J. Clin. Endocrinol. Metab. 2008;93:2633-2638.
ABSTRACT | FULL TEXT  

Different strategies for screening and prevention of type 2 diabetes in adults: cost effectiveness analysis
Gillies et al.
BMJ 2008;336:1180-1185.
ABSTRACT | FULL TEXT  

Themed Review: Lifestyle Treatment of the Metabolic Syndrome
Janiszewski et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:99-108.
ABSTRACT  

Cardiorespiratory Fitness as a Predictor of Cancer Mortality Among Men With Pre-Diabetes and Diabetes
Thompson et al.
Diabetes Care 2008;31:764-769.
ABSTRACT | FULL TEXT  

Glucose Homeostasis in Hypertensive Subjects
Korhonen et al.
Hypertension 2008;51:945-949.
ABSTRACT | FULL TEXT  

Glucose Indices, Health Behaviors, and Incidence of Diabetes in Australia: The Australian Diabetes, Obesity and Lifestyle Study
Magliano et al.
Diabetes Care 2008;31:267-272.
ABSTRACT | FULL TEXT  

Impact of Impaired Fasting Glucose on Cardiovascular Disease: The Framingham Heart Study
Levitzky et al.
J Am Coll Cardiol 2008;51:264-270.
ABSTRACT | FULL TEXT  

The Dipeptidyl Peptidase-4 Inhibitor Vildagliptin Improves -Cell Function and Insulin Sensitivity in Subjects With Impaired Fasting Glucose
Utzschneider et al.
Diabetes Care 2008;31:108-113.
ABSTRACT | FULL TEXT  

Cost-Effectiveness of Screening for Pre-Diabetes Among Overweight and Obese U.S. Adults
Hoerger et al.
Diabetes Care 2007;30:2874-2879.
ABSTRACT | FULL TEXT  

Population-Based Incidence of Type 2 Diabetes in Northern Spain: The Asturias Study
Valdes et al.
Diabetes Care 2007;30:2258-2263.
ABSTRACT | FULL TEXT  

Elevated Cystatin C Concentration and Progression to Pre-Diabetes: The Western New York Study
Donahue et al.
Diabetes Care 2007;30:1724-1729.
ABSTRACT | FULL TEXT  

Impaired Fasting Glucose and Impaired Glucose Tolerance: Implications for care
Nathan et al.
Diabetes Care 2007;30:753-759.
FULL TEXT  

Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis
Gillies et al.
BMJ 2007;334:299-299.
ABSTRACT | FULL TEXT  

Progression From Newly Acquired Impaired Fasting Glusose to Type 2 Diabetes
Nichols et al.
Diabetes Care 2007;30:228-233.
ABSTRACT | FULL TEXT  

High Risk of Cardiovascular Mortality in Individuals With Impaired Fasting Glucose Is Explained by Conversion to Diabetes: The Hoorn Study
Rijkelijkhuizen et al.
Diabetes Care 2007;30:332-336.
ABSTRACT | FULL TEXT  

Diabetes known or newly detected, but not impaired glucose regulation, has a negative influence on 1-year outcome in patients with coronary artery disease: a report from the Euro Heart Survey on diabetes and the heart
Lenzen et al.
Eur Heart J 2006;27:2969-2974.
ABSTRACT | FULL TEXT  

Sagittal abdominal diameter: no advantage compared with other anthropometric measures as a correlate of components of the metabolic syndrome in elderly from the Hoorn Study.
Mukuddem-Petersen et al.
Am. J. Clin. Nutr. 2006;84:995-1002.
ABSTRACT | FULL TEXT  

Associations of adiponectin levels with incident impaired glucose metabolism and type 2 diabetes in older men and women: the hoorn study.
Snijder et al.
Diabetes Care 2006;29:2498-2503.
ABSTRACT | FULL TEXT  

The Answer to Diabetes Prevention: Science, Surgery, Service Delivery, or Social Policy?
Colagiuri et al.
Am. J. Public Health 2006;96:1562-1569.
ABSTRACT | FULL TEXT  

Use of HbA1c in Predicting Progression to Diabetes in French Men and Women: Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR)
Droumaguet et al.
Diabetes Care 2006;29:1619-1625.
ABSTRACT | FULL TEXT  

Counterpoint: Impaired Fasting Glucose: The Case Against the New American Diabetes Association Guidelines
Dekker and Balkau
Diabetes Care 2006;29:1173-1175.
FULL TEXT  

Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease.
Thornley-Brown et al.
Arch Intern Med 2006;166:797-805.
ABSTRACT | FULL TEXT  

Prevalence of Diabetes and Impaired Glucose Tolerance in 64-Year-Old Swedish Women: Experiences of using repeated oral glucose tolerance tests
Brohall et al.
Diabetes Care 2006;29:363-367.
ABSTRACT | FULL TEXT  

What aspects of body fat are particularly hazardous and how do we measure them?
Snijder et al.
Int J Epidemiol 2006;35:83-92.
FULL TEXT  

Prevalence of Impaired Fasting Glucose and Its Relationship With Cardiovascular Disease Risk Factors in US Adolescents, 1999-2000
Williams et al.
Pediatrics 2005;116:1122-1126.
ABSTRACT | FULL TEXT  

Role of Insulin Secretion and Sensitivity in the Evolution of Type 2 Diabetes in the Diabetes Prevention Program: Effects of Lifestyle Intervention and Metformin
The Diabetes Prevention Program Research Group
Diabetes 2005;54:2404-2414.
ABSTRACT | FULL TEXT  

Lack of Association of Physical Activity and Obesity with Incident Pancreatic Cancer in Elderly Women
Sinner et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:1571-1573.
FULL TEXT  

Impaired Fasting Glucose and Cardiovascular Outcomes in Postmenopausal Women with Coronary Artery Disease
Kanaya et al.
ANN INTERN MED 2005;142:813-820.
ABSTRACT | FULL TEXT  

Interactions of dietary fat intake and the hepatic lipase -480C->T polymorphism in determining hepatic lipase activity: the Hoorn Study
Bos et al.
Am. J. Clin. Nutr. 2005;81:911-915.
ABSTRACT | FULL TEXT  

Impaired glucose tolerance and impaired fasting glucose -- a review of diagnosis, clinical implications and management
Petersen and McGuire
Diabetes and Vascular Disease Research 2005;2:9-15.
ABSTRACT  

Prevalence of Abnormal Glucose Tolerance Following a Transient Ischemic Attack or Ischemic Stroke
Kernan et al.
Arch Intern Med 2005;165:227-233.
ABSTRACT | FULL TEXT  

Preventing Type 2 Diabetes Mellitus
Curtis and Wilson
J Am Board Fam Med 2005;18:37-43.
ABSTRACT | FULL TEXT  

Predictors of and Longitudinal Changes in Insulin Sensitivity and Secretion Preceding Onset of Type 2 Diabetes
Lyssenko et al.
Diabetes 2005;54:166-174.
ABSTRACT | FULL TEXT  

Prospective Study of Social and Other Risk Factors for Incidence of Type 2 Diabetes in the Whitehall II Study
Kumari et al.
Arch Intern Med 2004;164:1873-1880.
ABSTRACT | FULL TEXT  

Population-Based Incidence Rates and Risk Factors for Type 2 Diabetes in White Individuals: The Bruneck Study
Bonora et al.
Diabetes 2004;53:1782-1789.
ABSTRACT | FULL TEXT  

Exercise training: can it improve cardiovascular health in patients with type 2 diabetes?
Stewart
Br. J. Sports. Med. 2004;38:250-252.
FULL TEXT  

Using Metabolic Syndrome Traits for Efficient Detection of Impaired Glucose Tolerance
Meigs et al.
Diabetes Care 2004;27:1417-1426.
ABSTRACT | FULL TEXT  

Physical Activity, Body Mass Index, and Risk of Type 2 Diabetes in Patients With Normal or Impaired Glucose Regulation
Hu et al.
Arch Intern Med 2004;164:892-896.
ABSTRACT | FULL TEXT  

The Relationship of Lipoprotein Lipase Activity and LDL size Is Dependent on Glucose Metabolism in an Elderly Population: The Hoorn Study
Bos et al.
Diabetes Care 2004;27:796-798.
FULL TEXT  

The Metabolic Syndrome is associated with advanced vascular damage in patients with coronary heart disease, stroke, peripheral arterial disease or abdominal aortic aneurysm
Olijhoek et al.
Eur Heart J 2004;25:342-348.
ABSTRACT | FULL TEXT  

Trunk Fat and Leg Fat Have Independent and Opposite Associations With Fasting and Postload Glucose Levels: The Hoorn Study
Snijder et al.
Diabetes Care 2004;27:372-377.
ABSTRACT | FULL TEXT  

A simple pragmatic system for detecting new cases of type 2 diabetes and impaired fasting glycaemia in primary care
Greaves et al.
Fam Pract 2004;21:57-62.
ABSTRACT | FULL TEXT  

Prevention or Delay of Type 2 Diabetes
Diabetes Care 2004;27:s47-47.
FULL TEXT  

Predictive Properties of Impaired Glucose Tolerance for Cardiovascular Risk Are Not Explained by the Development of Overt Diabetes During Follow-Up
Qiao et al.
Diabetes Care 2003;26:2910-2914.
ABSTRACT | FULL TEXT  

Use of Growth Hormone in Elderly Individuals
Malozowski
JAMA 2003;290:462-462.
FULL TEXT  

The Natural History of Progression From Normal Glucose Tolerance to Type 2 Diabetes in the Baltimore Longitudinal Study of Aging
Meigs et al.
Diabetes 2003;52:1475-1484.
ABSTRACT | FULL TEXT  

Associations of hip and thigh circumferences independent of waist circumference with the incidence of type 2 diabetes: the Hoorn Study
Snijder et al.
Am. J. Clin. Nutr. 2003;77:1192-1197.
ABSTRACT | FULL TEXT  

Prospective Relation of C-Reactive Protein With Type 2 Diabetes: Response to Han et al.
Snijder et al.
Diabetes Care 2003;26:1656-1657.
FULL TEXT  

Lack of Association between Serum Paraoxonase 1 Activities and Increased Oxidized Low-Density Lipoprotein Levels in Impaired Glucose Tolerance and Newly Diagnosed Diabetes Mellitus
Kopprasch et al.
J. Clin. Endocrinol. Metab. 2003;88:1711-1716.
ABSTRACT | FULL TEXT  

Estimated Number of Adults With Prediabetes in the U.S. in 2000: Opportunities for prevention
Benjamin et al.
Diabetes Care 2003;26:645-649.
ABSTRACT | FULL TEXT  

Comparison of a Clinical Model, the Oral Glucose Tolerance Test, and Fasting Glucose for Prediction of Type 2 Diabetes Risk in Japanese Americans
McNeely et al.
Diabetes Care 2003;26:758-763.
ABSTRACT | FULL TEXT  

Inflammatory Cytokines and the Risk to Develop Type 2 Diabetes: Results of the Prospective Population-Based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study
Spranger et al.
Diabetes 2003;52:812-817.
ABSTRACT | FULL TEXT  

Preventing type 2 diabetes: what have we learned?
Nathan
British Journal of Diabetes & Vascular Disease 2003;3:S6-S11.
ABSTRACT  

The Prevention or Delay of Type 2 Diabetes
Diabetes Care 2003;26:s62-69.
FULL TEXT  

A Quantitative Trait Locus Influencing Type 2 Diabetes Susceptibility Maps to a Region on 5q in an Extended French Family
Martin et al.
Diabetes 2002;51:3568-3572.
ABSTRACT | FULL TEXT  

Indices of Insulin Action, Disposal, and Secretion Derived From Fasting Samples and Clamps in Normal Glucose-Tolerant Black and White Children
Uwaifo et al.
Diabetes Care 2002;25:2081-2087.
ABSTRACT | FULL TEXT  

Identifying the Target Population for Primary Prevention: The Trade-Offs
Engelgau et al.
Diabetes Care 2002;25:2098-2099.
FULL TEXT  

Variations in Insulin Secretion in Carriers of the E23K Variant in the KIR6.2 Subunit of the ATP-Sensitive K+ Channel in the {beta}-Cell
't Hart et al.
Diabetes 2002;51:3135-3138.
ABSTRACT | FULL TEXT  

Targeting people with pre-diabetes
Narayan et al.
BMJ 2002;325:403-404.
FULL TEXT  

Tests of Glycemia for the Diagnosis of Type 2 Diabetes Mellitus
Barr et al.
ANN INTERN MED 2002;137:263-272.
ABSTRACT | FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
Clin. Diabetes 2002;20:109-116.
FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
Diabetes Spectr. 2002;15:147-157.
FULL TEXT  

The Prevention or Delay of Type 2 Diabetes
American Diabetes Association
Diabetes Care 2002;25:742-749.
FULL TEXT  

Variations in Insulin Secretion in Carriers of Gene Variants in IRS-1 and -2
't Hart et al.
Diabetes 2002;51:884-887.
ABSTRACT | FULL TEXT  

Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin
Diabetes Prevention Program Research Group
NEJM 2002;346:393-403.
ABSTRACT | FULL TEXT  

Fasting Versus Postload Glucose Levels: Why the controversy?
Gerstein
Diabetes Care 2001;24:1855-1857.
FULL TEXT