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Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?

Aims/Introduction:  To evaluate if hemoglobin A1c (A1C) can replace the use of the oral glucose tolerance test (OGTT) to diagnose diabetes in Chinese patients. Materials and Methods:  Subjects without pre‐existing diabetes were included in this community‐based study. Each participant received a 75‐g...

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Autores principales: Li, Hung‐Yuan, Ma, Wen‐Ya, Wei, Jung‐Nan, Lin, Mao‐Shin, Shih, Shyang‐Rong, Hung, Chi Sheng, Hua, Cyue‐Huei, Chuang, Lee‐Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014947/
https://www.ncbi.nlm.nih.gov/pubmed/24843574
http://dx.doi.org/10.1111/j.2040-1124.2011.00181.x
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author Li, Hung‐Yuan
Ma, Wen‐Ya
Wei, Jung‐Nan
Lin, Mao‐Shin
Shih, Shyang‐Rong
Hung, Chi Sheng
Hua, Cyue‐Huei
Chuang, Lee‐Ming
author_facet Li, Hung‐Yuan
Ma, Wen‐Ya
Wei, Jung‐Nan
Lin, Mao‐Shin
Shih, Shyang‐Rong
Hung, Chi Sheng
Hua, Cyue‐Huei
Chuang, Lee‐Ming
author_sort Li, Hung‐Yuan
collection PubMed
description Aims/Introduction:  To evaluate if hemoglobin A1c (A1C) can replace the use of the oral glucose tolerance test (OGTT) to diagnose diabetes in Chinese patients. Materials and Methods:  Subjects without pre‐existing diabetes were included in this community‐based study. Each participant received a 75‐g OGTT and A1C tests. Results:  A total of 1362 subjects, 512 men and 850 women, aged 18–88 years, were enrolled. The prevalence of diabetes was 7.4 and 7.3% by OGTT and by A1C ≥ 6.5% criteria, respectively. The optimal A1C cut‐off for diabetes defined by OGTT was 6.1%. The performance of A1C ≥ 6.1% to find diabetes by OGTT was poor, with a kappa 0.50, sensitivity 80% and specificity 91%. Using current criteria of fasting plasma glucose (FPG) < 5.56 mmol/L to exclude and ≥7 mmol/L to diagnose diabetes (FPG criterion), the sensitivity, specificity and OGTT required were 77.2, 100 and 13.5%, respectively. Using A1C < 5.9% to exclude and ≥7.0% to diagnose diabetes (A1C criterion), the sensitivity, specificity and OGTT required were 89.1, 99.8 and 26.5%, respectively. However, using FPG < 5.56 mmol/L and A1C < 6.1% to exclude, and A1C ≥ 7.0% to diagnose diabetes (A1C plus FPG criterion), the sensitivity, specificity and OGTT required were 85.2, 100 and 18.9%, respectively. Conclusions:  To screen for diabetes, the A1C criterion is more sensitive than the FPG criterion, with more OGTT needed. The A1C plus FPG criterion reduced the number of OGTT needed with acceptable sensitivity. A1C can guide, but cannot replace, OGTT to diagnose diabetes. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00181.x, 2011)
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spelling pubmed-40149472014-05-19 Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests? Li, Hung‐Yuan Ma, Wen‐Ya Wei, Jung‐Nan Lin, Mao‐Shin Shih, Shyang‐Rong Hung, Chi Sheng Hua, Cyue‐Huei Chuang, Lee‐Ming J Diabetes Investig Articles Aims/Introduction:  To evaluate if hemoglobin A1c (A1C) can replace the use of the oral glucose tolerance test (OGTT) to diagnose diabetes in Chinese patients. Materials and Methods:  Subjects without pre‐existing diabetes were included in this community‐based study. Each participant received a 75‐g OGTT and A1C tests. Results:  A total of 1362 subjects, 512 men and 850 women, aged 18–88 years, were enrolled. The prevalence of diabetes was 7.4 and 7.3% by OGTT and by A1C ≥ 6.5% criteria, respectively. The optimal A1C cut‐off for diabetes defined by OGTT was 6.1%. The performance of A1C ≥ 6.1% to find diabetes by OGTT was poor, with a kappa 0.50, sensitivity 80% and specificity 91%. Using current criteria of fasting plasma glucose (FPG) < 5.56 mmol/L to exclude and ≥7 mmol/L to diagnose diabetes (FPG criterion), the sensitivity, specificity and OGTT required were 77.2, 100 and 13.5%, respectively. Using A1C < 5.9% to exclude and ≥7.0% to diagnose diabetes (A1C criterion), the sensitivity, specificity and OGTT required were 89.1, 99.8 and 26.5%, respectively. However, using FPG < 5.56 mmol/L and A1C < 6.1% to exclude, and A1C ≥ 7.0% to diagnose diabetes (A1C plus FPG criterion), the sensitivity, specificity and OGTT required were 85.2, 100 and 18.9%, respectively. Conclusions:  To screen for diabetes, the A1C criterion is more sensitive than the FPG criterion, with more OGTT needed. The A1C plus FPG criterion reduced the number of OGTT needed with acceptable sensitivity. A1C can guide, but cannot replace, OGTT to diagnose diabetes. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00181.x, 2011) Blackwell Publishing Ltd 2012-06-06 2011-12-01 /pmc/articles/PMC4014947/ /pubmed/24843574 http://dx.doi.org/10.1111/j.2040-1124.2011.00181.x Text en © 2011 Asian Association for the Study of Diabetes and Blackwell Publishing Asia Pty Ltd
spellingShingle Articles
Li, Hung‐Yuan
Ma, Wen‐Ya
Wei, Jung‐Nan
Lin, Mao‐Shin
Shih, Shyang‐Rong
Hung, Chi Sheng
Hua, Cyue‐Huei
Chuang, Lee‐Ming
Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?
title Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?
title_full Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?
title_fullStr Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?
title_full_unstemmed Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?
title_short Hemoglobin A1c for the diagnosis of diabetes: To replace or to guide oral glucose tolerance tests?
title_sort hemoglobin a1c for the diagnosis of diabetes: to replace or to guide oral glucose tolerance tests?
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014947/
https://www.ncbi.nlm.nih.gov/pubmed/24843574
http://dx.doi.org/10.1111/j.2040-1124.2011.00181.x
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