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Glycated haemoglobin A 1 c for diagnosing diabetes in C hinese subjects over 50 years old: a community‐based cross‐sectional study
Author(s) -
Lin Shuo,
Hu Li,
Li Xiaofeng,
Chen Yanming,
Xu Haixia,
He Shengqing,
Ren Zhuozhuo,
Tang Xixiang,
Qiu Yawei,
Xu Jing,
Mu Panwei,
Zeng Longyi
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12202
Subject(s) - medicine , diabetes mellitus , glycated haemoglobin , receiver operating characteristic , plasma glucose , cross sectional study , glycated hemoglobin , area under the curve , glycosylated haemoglobin , endocrinology , gastroenterology , type 2 diabetes , pathology
Summary Objective Little is known about using glycated haemoglobin A 1 c ( HbA 1 c) to diagnose diabetes in C hinese subjects over 50 years old. This study aims to evaluate HbA 1 c in diagnosing diabetes and identify the optimal threshold to be used in C hinese community subjects aged over 50 years. Methods A community‐based cross‐sectional survey was conducted from O ctober 2010 to J anuary 2011 in S hipai community of G uangzhou, G uangdong, C hina. A total of 1494 subjects (72·8%) aged over 50 years were investigated. Fasting plasma glucose ( FPG 1st ) and HbA 1 c were assayed in each participant. Diabetic candidates with FPG 1st ≥ 5·6 mmol/l or HbA 1 c ≥ 39 mmol/mol (5·7%) were informed to undergo a 75‐g oral glucose tolerance test ( OGTT ). Diagnosis of diabetes was made by 1999 World Health Organization criteria. Sensitivity and specificity of HbA 1 c for diagnosing diabetes were calculated by receiver operating characteristics ( ROC ) curve. Results Among 1494 subjects, 161 subjects (10·8%) with previously diagnosed diabetes and 21 with missing data were excluded. Among the remaining 1312 subjects (87·8%), 861 subjects (65·6%) with either FPG 1st ≥ 5·6 mmol/l or HbA 1c ≥ 39 mmol/mol (5·7%) were invited to perform OGTT . Finally, 453 subjects (52·6%) performed OGTT ( FPG 2nd and 2‐h plasma glucose were measured) and 54 subjects (11·9%) were identified as being diabetes. The area under ROC curve was 0·916 (0·887–0·940) for HbA 1 c and 0·972 (0·953–0·985) for FPG 2nd in diagnosing diabetes ( P = 0·045). An HbA 1 c threshold of 48 mmol/mol (6·5%) yielded the highest combination of sensitivity (75·9%) and specificity (95·5%) for diagnosing diabetes. Conclusion An HbA 1 c threshold of 48 mmol/mol (6·5%) was highly specific and had a good sensitivity for diagnosing diabetes among Chinese subjects aged over 50 years with FPG ≥ 5·6 mmol/l or HbA 1 c ≥ 39 mmol/mol (5·7%). This threshold may be suitable for diagnosing diabetes in Chinese subjects over 50 years old.