Bimodality of 2-h Plasma Glucose Distributions in Whites
Open accessAbstract
OBJECTIVE—Several studies have shown a bimodal curve in the distribution of glucose in populations with a high prevalence of type 2 diabetes, but bimodality has not been reported among whites of Northern European ancestry. It is not clear whether this difference reflects the lower prevalence of diabetes, obscuring a second mode, or implies a more fundamental difference between whites and nonwhites. We investigate this issue by studying glucose distributions in older white patients. RESEARCH DESIGN AND METHODS—A study of diabetes was conducted among older community-dwelling white residents of a suburban Southern California community between 1984 and 1987. Two-hour plasma glucose data were collected from 2,326 older white men and women aged 23–92. To investigate bimodality of glucose distributions, we fit unimodal and bimodal normal models to 2-h plasma glucose concentrations transformed by the Box-Cox family of transformations. RESULTS—We found that the bimodal normal mixture model fit the data significantly better than the unimodal skewed distribution model for both sexes and all age-groups except those ≥80 years. The cut points separating the two modes were generally within the 11.1- to 13.6-mmol/l range. CONCLUSIONS—The bimodality of glucose distributions among whites, combined with previous findings, indicates that this phenomenon may be universal. A smaller second mode in our study compared with other studies suggests that whites have diabetes susceptibility but may require more obesity to demonstrate it. With increasing obesity in the U.S., the predicted epidemic of diabetes may affect all ethnic groups including whites.
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Wild, S., Roglic, G., Green, A., Sicree, R., & King, H. (2004) · Diabetes Care · doi:10.2337/diacare.27.5.1047 · Cited by 15,297 · see citing works
An Analysis of Transformations
Box, G. E. P., & Cox, D. R. (1964) · Journal of the Royal Statistical Society Series B (Statistical Methodology) · doi:10.1111/j.2517-6161.1964.tb00553.x · Cited by 15,059 · see citing works
Harris, M. I., Flegal, K. M., Cowie, C. C., Eberhardt, M. S., Goldstein, D. E., Little, R. R., Wiedmeyer, H.-M., & Byrd-Holt, D. D. (1998) · Diabetes Care · doi:10.2337/diacare.21.4.518 · Cited by 2,703 · see citing works
McLachlan, G. J. (1987) · Journal of the Royal Statistical Society Series C (Applied Statistics) · doi:10.2307/2347790 · Cited by 709 · see citing works
Diabetes mellitus in the Pima Indians: Incidence, risk factors and pathogenesis
Knowler, W. C., Pettitt, D. J., Saad, M. F., & Bennett, P. H. (1990) · Diabetes/Metabolism Reviews · doi:10.1002/dmr.5610060101 · Cited by 578 · see citing works
Microvascular complications of impaired glucose tolerance
Singleton, J. R., Smith, A. G., Russell, J. W., & Feldman, E. L. (2003) · Diabetes · doi:10.2337/diabetes.52.12.2867 · Cited by 372 · see citing works
The Inherited Basis of Diabetes Mellitus: Implications for the Genetic Analysis of Complex Traits
Florez, J. C., Hirschhorn, J., & Altshuler, D. (2003) · Annual Review of Genomics and Human Genetics · doi:10.1146/annurev.genom.4.070802.110436 · Cited by 329 · see citing works
Skewness in Commingled Distributions
MacLean, C. J., Morton, N. E., Elston, R. C., et al. (1976) · Biometrics · doi:10.2307/2529760 · Cited by 328 · see citing works
Engelgau, M. M., Thompson, T. J., Herman, W. H., Boyle, J. P., Aubert, R. E., Kenny, S. J., Badran, A., Sous, E. S., & Ali, M. A. (1997) · Diabetes Care · doi:10.2337/diacare.20.5.785 · Cited by 325 · see citing works
To The Pathogenesis of Diabetes Mellitus
van BEEK, C. (1954) · Gastroenterology · doi:10.1016/s0016-5085(54)80036-9 · Cited by 134 · see citing works
Thode, H. C., Finch, S. J., & Mendell, N. R. (1988) · Biometrics · doi:10.2307/2531747 · Cited by 131 · see citing works
Diabetes in the Pima Indians: Evidence of Bimodality in Glucose Tolerance Distributions
Rushforth, N. B., Bennett, P. H., Steinberg, A. G., Burch, T. A., & Miller, M. (1971) · Diabetes · doi:10.2337/diab.20.11.756 · Cited by 108 · see citing works
Bimodality of Fasting and Two-hour Glucose Tolerance Distributions in a Micronesian Population
Zimmet, P. (1978) · Diabetes · doi:10.2337/diab.27.8.793 · Cited by 83 · see citing works
Barrett-Connor, E. L. (1980) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112948 · Cited by 79 · see citing works
Self-citationRosenthal, M., McMahan, C. A., D, M. P. S. M., Eifler, C. W., Haffner, S. M., Hazuda, H. P., & Franco, L. J. (1985) · Journal of Chronic Diseases · doi:10.1016/0021-9681(85)90003-7 · Cited by 49 · see citing works
Bimodality of fasting and two-hour glucose tolerance distributions in a Micronesian population
Zimmet, P., & Whitehouse, S. (1978) · Diabetes · doi:10.2337/diabetes.27.8.793 · Cited by 48 · see citing works
FACTORS ASSOCIATED WITH THE DISTRIBUTION OF FASTING PLASMA GLUCOSE IN AN ADULT COMMUNITY
Barrett-Connor, E. L. (1980) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113021 · Cited by 35 · see citing works
Self-citationBimodality in glucose tolerance distributions in the urban Polynesian population of Western Samoa.
Raper, L., Taylor, R. J., Zimmet, P., Milne, B. J., & Balkau, B. (1984) · PubMed · Cited by 32 · see citing works
Bimodality in Blood Glucose Distribution
Lim, T. O., Bakri, R., Morad, Z., et al. (2002) · Diabetes Care · doi:10.2337/diacare.25.12.2212 · Cited by 30 · see citing works
Analysis of Tomato Root Initiation Using a Normal Mixture Distribution
Gutierrez, R. G., Carroll, R. J., Wang, N., et al. (1995) · Biometrics · doi:10.2307/2533276 · Cited by 30 · see citing works
Frontiers of diabetes research: current trends in non-insulin-dependent diabetes mellitus
Alberti, K., & Mazze, R. S. (1989) · Cited by 30 · see citing works
Ekoé, J. M. (1989) · Cited by 25 · see citing works
Ning, Y. M., & Finch, S. J. (2000) · Communications in Statistics - Simulation and Computation · doi:10.1080/03610910008813621 · Cited by 6 · see citing works
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- Authors
- Fan, J., May, S. J., Zhou, Y., & Barrett-Connor, E.
- Affiliations
- San Diego State University (US)
- University of California San Diego (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2005-06-01
- Volume
- 28
- Issue
- 6
- Pages
- 1451-1456
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2061050682
- Cited by
- 31
- References
- 24
- Citations by year
- 2021: 4 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 5
- FWCI
- 1.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK031801, DK-31801)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- 2-hour plasma glucose, type 2 diabetes, normal mixture models, Box-Cox transformation, older adults, Caucasian population, diabetes susceptibility, obesity, ethnic differences in diabetes, diabetes epidemic
- MeSH terms
- Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Models, Biological, Prevalence, Normal Distribution, White People
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