AbstractAims.To investigate the sensitivity of using fasting plasma glucose as the first line test to diagnose diabetes mellitus by comparison of established 1985 WHO diagnostic criteria with use of a fasting plasma glucose of ≥7 mmol/L as recommended by the ADA and endorsed by WHO.Method.Retrospective analysis of 1864 oral glucose tolerance tests undertaken in patients with a clinical suspicion of diabetes.Results.Using an FPG of ≥7 mmol/L alone resulted in a 17.4% reduction in the prevalence of DM when compared with 1985 WHO criteria and a 8.7% reduction in the prevalence of any abnormality of glucose tolerance. Overall concordance between the two methods of assessment was 68.9%. Of those classified as abnormal by WHO, 257/990 (26.0%) (75/592 (12.2%) DM and 185/378 (46.5%) IGT), would be reclassified as normal if only FPG were measured. 667 (35.8% of those tested) could be diagnosed as diabetic if either an FPG≥7 mmol/L or a 2 h PP level ≥11.1 mmol/L were considered, of whom 178 (26.7%) would be missed if only FPG were considered. Of those diagnosed as diabetic on the basis of an FPG ≥7 mmol/L, 96 (19.6%) had a 2 hour glucose concentration <11.1 mmol/L. Using a reduced cut‐off level to prompt further investigation with an OGTT improved sensitivity though at the expense of specificity and with the requirement for an increasing number of OGTTs.Conclusion.In people where there is a clinical suspicion of diabetes, using fasting plasma glucose alone for diagnosis will miss a significant number with abnormal glucose tolerance. Until long term outcome data are available, diabetes should not be excluded without a measure of either a post‐prandial glucose level or OGTT. Copyright © 2001 John Wiley & Sons, Ltd.

Objective: To determine the sensitivity, specificity and predictive value of the pyruvate dehydrogenase (PDH) activity inhibition test for the diagnosis of primary biliary cirrhosis (PBC).Design: Application of PDH inhibition test to sera from patients with PBC, clinically and serologically related diseases, chronic liver disease controls and normal controls.Methods: Inhibition of the in vitro activity of PDH by pre-incubation with sera.Results: Pyruvate dehydrogenase activity was inhibited by sera from all patients with PBC, from four out of 41 with chronic active hepatitis, from three out of 35 with progressive systemic sclerosis and from none of those with chronic liver disease, surgical obstructive jaundice or from normal controls.Conclusion: Our results show a sensitivity of 100%, specificity of 96% and overall positive predictive value of 89% and suggest that the PDH inhibition test is a useful addition to the repertoire of chemical pathology laboratories screening for PBC.

AbstractThe effectiveness of serum fructosamine as a screening test for diabetes mellitus was assessed by comparison with the response to a 75g oral glucose tolerance test (OGTT) in 114 non‐pregnant and 36 pregnant individuals. The mean fructosamine level was higher in diabetic than in normal subjects whereas the mean in subjects with impaired glucose tolerance was not significantly different from that of normal controls. In predicting an abnormal response to OGTT, the sensitivity of fructosamine was only 35%. Pregnant subjects had a lower mean fructosamine than normal; none of nine subjects with gestational diabetes had an elevated level. We conclude that fructosamine has no place as a diagnostic screening test for diabetes in pregnancy.

This paper describes the inhibitory effect of sera from 39 patients with primary biliary cirrhosis (PBC), 41 patients with chronic liver disease other than PBC, and 20 normal controls, on the activities of the pyruvate dehydrogenase (PDH), the branched chain 2-oxoacid dehydrogenase (BCOAD), and the 2-oxoglutarate dehydrogenase (OGDH) complexes. Sera from patients with PBC significantly inhibited the activity of PDH in all 39 patients, BCOAD in 28 out of 39 and OGDH in three out of 39 cases. Sera from two patient with chronic active hepatitis (CAH) [both antimitochondrial antibody (AMA) positive] inhibited activity of PDH but not BCOAD or OGDH. None of the remaining 39 patients, with chronic liver disease or the 20 normal controls inhibited activity of any of the enzymes. Activities of the E1 (pyruvate decarboxylase) and E3 (dihydrolipoamide dehydrogenase) components of PDH were unaffected by PBC sera. This implies that the inhibitory effect is confined to E2 (dihydrolipoamide acetyltransferase), though an inhibitory effect on protein-X cannot be excluded.

Conference Abstract| January 01 1990 Primary Biliary Cirrhosis Serum Inhibits Activity of Pyruvate, Oxoglutarate and Branched Chain Oxo Acid Dehydrogenase JP Begley; JP Begley 1Departments of Chemical Pathology and Medicine, Bristol Royal Infirmary, Bristol BS2 8HW and The Department of Biochemistry, University of Bristol Search for other works by this author on: This Site PubMed Google Scholar R Barry; R Barry 1Departments of Chemical Pathology and Medicine, Bristol Royal Infirmary, Bristol BS2 8HW and The Department of Biochemistry, University of Bristol Search for other works by this author on: This Site PubMed Google Scholar RM Denton; RM Denton 1Departments of Chemical Pathology and Medicine, Bristol Royal Infirmary, Bristol BS2 8HW and The Department of Biochemistry, University of Bristol Search for other works by this author on: This Site PubMed Google Scholar D Stansbie D Stansbie 1Departments of Chemical Pathology and Medicine, Bristol Royal Infirmary, Bristol BS2 8HW and The Department of Biochemistry, University of Bristol Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1990) 78 (s22): 1P. https://doi.org/10.1042/cs078001P Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation JP Begley, R Barry, RM Denton, D Stansbie; Primary Biliary Cirrhosis Serum Inhibits Activity of Pyruvate, Oxoglutarate and Branched Chain Oxo Acid Dehydrogenase. Clin Sci (Lond) 1 January 1990; 78 (s22): 1P. doi: https://doi.org/10.1042/cs078001P Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1990 The Biochemical Society and the Medical Research Society1990 Article PDF first page preview Close Modal You do not currently have access to this content.