Cargando…
The Utility of HbA1c as a Diagnostic Criterion of Diabetes
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 w...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Academy of Family Medicine
2011
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383149/ https://www.ncbi.nlm.nih.gov/pubmed/22745876 http://dx.doi.org/10.4082/kjfm.2011.32.7.383 |
_version_ | 1782236590095990784 |
---|---|
author | Kim, Hee-Jung Choi, Eun Young Park, Eal Whan Cheong, Yoo Seock Lee, Hong-Yoen Kim, Ji Hyun |
author_facet | Kim, Hee-Jung Choi, Eun Young Park, Eal Whan Cheong, Yoo Seock Lee, Hong-Yoen Kim, Ji Hyun |
author_sort | Kim, Hee-Jung |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-3383149 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | The Korean Academy of Family Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-33831492012-06-28 The Utility of HbA1c as a Diagnostic Criterion of Diabetes Kim, Hee-Jung Choi, Eun Young Park, Eal Whan Cheong, Yoo Seock Lee, Hong-Yoen Kim, Ji Hyun Korean J Fam Med Original Article 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. The Korean Academy of Family Medicine 2011-11 2011-11-30 /pmc/articles/PMC3383149/ /pubmed/22745876 http://dx.doi.org/10.4082/kjfm.2011.32.7.383 Text en Copyright © 2011 The Korean Academy of Family Medicine http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Hee-Jung Choi, Eun Young Park, Eal Whan Cheong, Yoo Seock Lee, Hong-Yoen Kim, Ji Hyun The Utility of HbA1c as a Diagnostic Criterion of Diabetes |
title | The Utility of HbA1c as a Diagnostic Criterion of Diabetes |
title_full | The Utility of HbA1c as a Diagnostic Criterion of Diabetes |
title_fullStr | The Utility of HbA1c as a Diagnostic Criterion of Diabetes |
title_full_unstemmed | The Utility of HbA1c as a Diagnostic Criterion of Diabetes |
title_short | The Utility of HbA1c as a Diagnostic Criterion of Diabetes |
title_sort | utility of hba1c as a diagnostic criterion of diabetes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383149/ https://www.ncbi.nlm.nih.gov/pubmed/22745876 http://dx.doi.org/10.4082/kjfm.2011.32.7.383 |
work_keys_str_mv | AT kimheejung theutilityofhba1casadiagnosticcriterionofdiabetes AT choieunyoung theutilityofhba1casadiagnosticcriterionofdiabetes AT parkealwhan theutilityofhba1casadiagnosticcriterionofdiabetes AT cheongyooseock theutilityofhba1casadiagnosticcriterionofdiabetes AT leehongyoen theutilityofhba1casadiagnosticcriterionofdiabetes AT kimjihyun theutilityofhba1casadiagnosticcriterionofdiabetes AT kimheejung utilityofhba1casadiagnosticcriterionofdiabetes AT choieunyoung utilityofhba1casadiagnosticcriterionofdiabetes AT parkealwhan utilityofhba1casadiagnosticcriterionofdiabetes AT cheongyooseock utilityofhba1casadiagnosticcriterionofdiabetes AT leehongyoen utilityofhba1casadiagnosticcriterionofdiabetes AT kimjihyun utilityofhba1casadiagnosticcriterionofdiabetes |