Open AccessHbA1c and the diagnosis of diabetes and prediabetes in a middle‐aged and elderly H an population from northwest C hina (HbA1c与中国西北部地区中老年汉族人群糖尿病和糖尿病前期的诊断)
Author(s) -
Wu Shengli,
Yi Fengshou,
Zhou Chao,
Zhang Mintao,
Zhu Yujing,
Tuniyazi Yilihamu,
Huang Lijuan,
Huang Xuefang,
Wang Fugang,
Bi Yufang,
Ning Guang
Publication year - 2013
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.12035
Subject(s) - prediabetes , medicine , diabetes mellitus , receiver operating characteristic , impaired fasting glucose , confidence interval , impaired glucose tolerance , population , area under the curve , glucose tolerance test , type 2 diabetes , endocrinology , insulin resistance , environmental health
Objective To identify the optimal threshold of HbA1c and to evaluate the predictive performance of HbA1c levels in diagnosing diabetes and prediabetes in a middle‐aged and elderly H an C hinese population from northwest C hina. Methods In all, 3354 participants aged ≥40 years with no history of diabetes from northwest C hina were enrolled in the present cross‐sectional study. All subjects underwent a 75‐g oral glucose tolerance test ( OGTT ), as well as HbA1c testing. HbA1c thresholds for diagnosing diabetes and prediabetes were identified by the highest sum of sensitivity and specificity of each cut‐off point, and the receiver operating characteristic ( ROC ) curve was used to evaluate the diagnostic accuracy of the HbA1c threshold. Results The mean (± SD ) age of the participants was 57 ± 8 years, and 70.75% were women. Based on results of the OGTT , 1347 (40.16%) subjects had impaired fasting glucose and/or impaired glucose tolerance, and 725 (21.62%) had diabetes. The area under the ROC curve for detecting undiagnosed diabetes and prediabetes by HbA1c levels was 0.810 (95% confidence interval [ CI ] 0.796–0.823) and 0.732 (95% CI 0.717–0.747), respectively. HbA1c threshold of 6.4% and 6.1% produced the highest sum of sensitivity (60.00% and 61.49%) and specificity (87.33% and 73.24%) for diagnosing diabetes and prediabetes, respectively. Conclusion HbA1c is an effective and convenient method for diagnosing diabetes and prediabetes. HbA1c thresholds of 6.4% and 6.1% may be used as diagnostic criteria for diabetes and prediabetes, respectively, in the H an C hinese population living in northwest C hina.