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- Title
Reference range for fasting blood sugar using generalized additive model for location, scale and shape: A population study in Mashhad (Iran).
- Authors
Esmaily, Habibollah; Kiani, Omid; Miri, Hamid Heidarian; Ghayour-Mobarhan, Majid
- Abstract
Introduction: Diabetes is one of most common chronic and noncommunicable disease, with many complications including renal failure, blindness and non-traumatic amputation. Prevention diabetes of is possible through monitoring and control of blood glucose levels. Reference plots are used to screen those with abnormal Fasting Blood Sugar (FBS). The problem is that a reference plot derived in a specific population cannot be efficiently used in other population with different characteristics. The rational is that people are compared with their population FBS values. The present study aimed to figure out the reference plots for FBS in the population of Mashhad aged 35 to 64 years. Methods: We used data from Mashhad Study with a sample size of 3874 aged 35 to 64 living in Mashhad. The dataset contained sex, age, and FBS. Exclusion criteria based on clinical history and laboratory tests to define the reference individuals. Generalized Additive Model for Location Scale and Shape (GAMLSS) was fitted to the data and the reference values were predicted according to the regression coefficients. In order to inquire the goodness-of-fit in GAMLSS we used worm plot and Q-test. All statistical analysis was performed by using statistical software R version 3.0.1 and the significance level was set to 0.05 as usual. Results: Of the total sample size 40.2% was men and 59.6% was women. Mean and standard deviation of age were 45.04 and 8.96 respectively. The main results of this study include values of 5th, 10th, 25th, 50th, 75th, 90th, 95th percentiles for FBS according to sex and age. FBS showed an increasing trend with age in both sexes. GAMLSS showed that borderline FBS levels for men and women aged 35-64 years were increased from 97 to 101 mg/dl and 94 to 104 mg/dl respectively. The ranges for defining high FBS levels were increased from 111 to 117 mg/dl in men and 108 to 119 mg/dl in women. Using Mann-Whitney nonparametric test, for FBS was not significantly different statistics of men compared with their corresponding range of women (P=0.80). Conclusion: GAMLSS could be used to determine the appropriate reference ranges for FBS and often provide more information rather than ordinary regression analysis. Furthermore, this model result in more robust estimation in the presence of outlier and is able to fit a regression line for desired percentiles. These findings could be used in local preventive and health policy plans.
- Publication
Medical journal of Mashhad University of Medical Sciences, 2016, Vol 59, p24
- ISSN
1735-4013
- Publication type
Academic Journal