The Utility of HbA1c as a Diagnostic Criterion of Diabetes / 가정의학회지
Korean Journal of Family Medicine
;
: 383-389, 2011.
Article
in English
| WPRIM
| ID: wpr-212472
ABSTRACT
BACKGROUND:
Hemoglobin A1c (HbA1c) was adopted as a new standard criterion for diagnosing diabetes. We investigated the diagnostic utility of HbA1c by comparing the 2003 American Diabetes Association (ADA) diagnostic criteria of diabetes with HbA1c of 6.5%. Furthermore, the cut-off value for HbA1c was investigated using receiver operating characteristic curves.METHODS:
This study included 224 subjects without a history of diabetes that had a fasting plasma glucose level of above 100 mg/dL. The subjects had undergone a 75 g oral glucose tolerance test, and diabetes was defined as according to 2003 ADA criteria.RESULTS:
The prevalence of newly diagnosed diabetes was 58.2% by the 2003 ADA criteria, and 47.8% by HbA1c of 6.5%, which underestimated the prevalence of diabetes. Compared with the 2003 ADA criteria, the sensitivity and specificity of HbA1c of 6.5% were 73.5% and 89.1%, respectively. The kappa index of agreement between 2003 ADA and HbA1c criteria was 0.60. The cut-off point of HbA1c for diagnosing diabetes was 6.45% (sensitivity, 73.3%; specificity, 88.2%; area under the curve, 0.85). HbA1c was significantly associated with fasting glucose (r = 0.82, P < 0.01), postprandial glucose (r = 0.78, P < 0.01), and homeostasis model assessment of insulin resistance (r = 0.16, P < 0.05).CONCLUSION:
For high risk patients whose fasting glucose was more than 100 mg/dL, HbA1c criterion underestimated the prevalence of newly diagnosed diabetes compared to the 2003 ADA criteria, and showed moderate agreement. The cut-off value for HbA1c was 6.45%, which was similar to the recommended diagnostic criterion of HbA1c by the 2009 ADA.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Plasma
/
Glycated Hemoglobin
/
Hemoglobins
/
Insulin Resistance
/
Prevalence
/
ROC Curve
/
Sensitivity and Specificity
/
Fasting
/
Glucose
/
Glucose Tolerance Test
Type of study:
Diagnostic study
/
Prevalence study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Korean Journal of Family Medicine
Year:
2011
Type:
Article
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