Prediction Model for Glucose Metabolism Based on Lipid Metabolism

Abstract

Summary Objectives: We developed a robust, long-term clinical prediction model to predict conditions leading to early diabetes using laboratory values other than blood glucose and insulin levels. Our model protects against missing data and noise that occur during long-term analysis. Methods: Results of a 75-g oral glucose tolerance test (OGTT) were divided into three groups: diabetes, impaired glucose tolerance (IGT), and normal (n = 114, 235, and 325, respectively). For glucose metabolic and lipid metabolic parameters, near 30-day mean values and 10-year integrated values were compared. The relation between high-density lipoprotein cholesterol (HDL-C) and variations in HbA1c was analyzed in 158 patients. We also constructed a state space model consisting of an observation model (HDL-C and HbA1c) and an internal model (disorders of lipid metabolism and glucose metabolism) and applied this model to 116 cases. Results: The root mean square error between the observed HbA1c and predicted HbA1c was 0.25. Conclusions: In the observation model, HDL-C levels were useful for prediction of increases in HbA1c. Even with numerous missing values over time, as occurs in clinical practice, clinically valid predictions can be made using this state space model.