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Glycated haemoglobin A1c for diagnosing diabetes in Chinese population: cross sectional epidemiological survey.

Bao Y, Ma X, Li H, Zhou M, Hu C, Wu H, Tang J, Hou X, Xiang K, Jia W - BMJ (2010)

Bottom Line: Multistage stratified cross sectional epidemiological survey.Very high specificity (96.1%, 95% confidence interval 95.5% to 96.7%) was achieved at an HbA(1c) threshold of 6.3% (2 SD above the normal mean).This optimal HbA(1c) threshold may be suitable as a diagnostic criterion for diabetes in Chinese adults when fasting plasma glucose and oral glucose tolerance tests are not available.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai 200233, China.

ABSTRACT

Objectives: To evaluate haemoglobin A1c (HbA(1c)) in diagnosing diabetes and identify the optimal HbA(1c) threshold to be used in Chinese adults.

Design: Multistage stratified cross sectional epidemiological survey.

Setting: Shanghai, China, 2007-8.

Participants: 4886 Chinese adults over 20 years of age with no history of diabetes.

Main outcome measures: Performance of HbA(1c) at increasing thresholds for diagnosing diabetes.

Results: The area under the receiver operating characteristics curve for detecting undiagnosed diabetes was 0.856 (95% confidence interval 0.828 to 0.883) for HbA(1c) alone and 0.920 (0.900 to 0.941) for fasting plasma glucose alone. Very high specificity (96.1%, 95% confidence interval 95.5% to 96.7%) was achieved at an HbA(1c) threshold of 6.3% (2 SD above the normal mean). Moreover, the corresponding sensitivity was 62.8% (57.1% to 68.3%), which was equivalent to that of a fasting plasma glucose threshold of 7.0 mmol/l (57.5%, 51.7% to 63.1%) in detecting undiagnosed diabetes. In participants at high risk of diabetes, the HbA(1c) threshold of 6.3% showed significantly higher sensitivity (66.9%, 61.0% to 72.5%) than both fasting plasma glucose >or=7.0 mmol/l (54.4%, 48.3% to 60.4%) and HbA(1c) >or=6.5% (53.7%, 47.6% to 59.7%) (P<0.01).

Conclusions: An HbA(1c) threshold of 6.3% was highly specific for detecting undiagnosed diabetes in Chinese adults and had sensitivity similar to that of using a fasting plasma glucose threshold of 7.0 mmol/l. This optimal HbA(1c) threshold may be suitable as a diagnostic criterion for diabetes in Chinese adults when fasting plasma glucose and oral glucose tolerance tests are not available.

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Fig 1 Flow diagram of recruitment of participants
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fig1: Fig 1 Flow diagram of recruitment of participants

Mentions: The final dataset included 4886 participants (1828 men and 3058 women) aged over 20 (median 49.4, interquartile range 37.9-57.7 years) from May 2007 to August 2008 (fig 1). Table 1 shows the clinical characteristics of the participants. We found no significant differences in age, low density lipoprotein cholesterol, fasting plasma glucose, and two hour post-load plasma glucose between men and women. Women had lower values of body mass index, waist circumference, blood pressure, triglycerides, and HbA1c and higher levels of total cholesterol and high density lipoprotein cholesterol than did men (all P<0.01). The percentage of undiagnosed diabetes in women was significantly lower than that in men (P<0.01).


Glycated haemoglobin A1c for diagnosing diabetes in Chinese population: cross sectional epidemiological survey.

Bao Y, Ma X, Li H, Zhou M, Hu C, Wu H, Tang J, Hou X, Xiang K, Jia W - BMJ (2010)

Fig 1 Flow diagram of recruitment of participants
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2871988&req=5

fig1: Fig 1 Flow diagram of recruitment of participants
Mentions: The final dataset included 4886 participants (1828 men and 3058 women) aged over 20 (median 49.4, interquartile range 37.9-57.7 years) from May 2007 to August 2008 (fig 1). Table 1 shows the clinical characteristics of the participants. We found no significant differences in age, low density lipoprotein cholesterol, fasting plasma glucose, and two hour post-load plasma glucose between men and women. Women had lower values of body mass index, waist circumference, blood pressure, triglycerides, and HbA1c and higher levels of total cholesterol and high density lipoprotein cholesterol than did men (all P<0.01). The percentage of undiagnosed diabetes in women was significantly lower than that in men (P<0.01).

Bottom Line: Multistage stratified cross sectional epidemiological survey.Very high specificity (96.1%, 95% confidence interval 95.5% to 96.7%) was achieved at an HbA(1c) threshold of 6.3% (2 SD above the normal mean).This optimal HbA(1c) threshold may be suitable as a diagnostic criterion for diabetes in Chinese adults when fasting plasma glucose and oral glucose tolerance tests are not available.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai 200233, China.

ABSTRACT

Objectives: To evaluate haemoglobin A1c (HbA(1c)) in diagnosing diabetes and identify the optimal HbA(1c) threshold to be used in Chinese adults.

Design: Multistage stratified cross sectional epidemiological survey.

Setting: Shanghai, China, 2007-8.

Participants: 4886 Chinese adults over 20 years of age with no history of diabetes.

Main outcome measures: Performance of HbA(1c) at increasing thresholds for diagnosing diabetes.

Results: The area under the receiver operating characteristics curve for detecting undiagnosed diabetes was 0.856 (95% confidence interval 0.828 to 0.883) for HbA(1c) alone and 0.920 (0.900 to 0.941) for fasting plasma glucose alone. Very high specificity (96.1%, 95% confidence interval 95.5% to 96.7%) was achieved at an HbA(1c) threshold of 6.3% (2 SD above the normal mean). Moreover, the corresponding sensitivity was 62.8% (57.1% to 68.3%), which was equivalent to that of a fasting plasma glucose threshold of 7.0 mmol/l (57.5%, 51.7% to 63.1%) in detecting undiagnosed diabetes. In participants at high risk of diabetes, the HbA(1c) threshold of 6.3% showed significantly higher sensitivity (66.9%, 61.0% to 72.5%) than both fasting plasma glucose >or=7.0 mmol/l (54.4%, 48.3% to 60.4%) and HbA(1c) >or=6.5% (53.7%, 47.6% to 59.7%) (P<0.01).

Conclusions: An HbA(1c) threshold of 6.3% was highly specific for detecting undiagnosed diabetes in Chinese adults and had sensitivity similar to that of using a fasting plasma glucose threshold of 7.0 mmol/l. This optimal HbA(1c) threshold may be suitable as a diagnostic criterion for diabetes in Chinese adults when fasting plasma glucose and oral glucose tolerance tests are not available.

Show MeSH
Related in: MedlinePlus