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Comparing glucose and hemoglobin A 1c diagnostic tests among a high metabolic risk Hispanic population
Author(s) -
VegaVázquez Mónica A.,
RamírezVick Margarita,
MuñozTorres Francisco J.,
GonzálezRodríguez Loida A.,
Joshipura Kaumudi
Publication year - 2017
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2874
Subject(s) - prediabetes , medicine , diabetes mellitus , glycated hemoglobin , glycemic , concordance , body mass index , impaired glucose tolerance , endocrinology , waist , population , overweight , insulin resistance , hemoglobin a , homeostatic model assessment , glucose tolerance test , type 2 diabetes , environmental health
Background Compare glycated hemoglobin (HbA 1c ) diagnostic tests for prediabetes and diabetes with plasma glucose criteria and compare the metabolic profiles of people classified by HbA 1c versus by glucose levels. Methods Participants were recruited for the San Juan Overweight Adults Longitudinal Study. The participants were primarily Hispanic (98%), without previously diagnosed diabetes, and aged 40 to 65 years. Participants classified as normal glycemic, prediabetes, or diabetes on the basis of baseline HbA 1c and plasma glucose criteria were compared with respect to baseline cardiometabolic factors. Results The 1342 participants had a mean age of 50.5 ± 6.8 years and 28% were men. Thirty‐one percent were diagnosed with prediabetes by plasma glucose criteria and 53.4% by HbA 1c , and 8.1% were diagnosed with diabetes by plasma glucose criteria and 6.3% by HbA 1c ; overall concordance rate was 55.1%. The area under the receiver operating characteristic curve of HbA 1c compared to plasma glucose criteria was 0.62 for impaired glucose and 0.76 for diabetes. A worse cardiometabolic profile was seen within subgroups that met HbA 1c and plasma glucose criteria for diabetes or prediabetes. Those diagnosed with prediabetes by plasma glucose criteria had significantly higher systolic blood pressure and higher homeostatic model assessment than those diagnosed using HbA 1c . Participants diagnosed with diabetes by plasma glucose criteria had lower body mass index, smaller waist circumference, and lower insulinogenic and disposition indices, but higher homeostatic model assessment of insulin resistance, than those diagnosed by HbA 1c . Conclusions Low concordance was seen between HbA 1c and glucose measurements. The HbA 1c is not a good test for prediabetes but shows reasonable validity for diabetes in this high‐risk predominantly female Hispanic population. People classified by HbA 1c , plasma glucose criteria, or both show different metabolic profiles; a combined test may be ideal.