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KMID : 1101420170490030239
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Korean Journal of Clinical Laboratory Science
2017 Volume.49 No. 3 p.239 ~ p.247
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The Distribution and Characteristics of Abnormal Findings Regarding Fasting Plasma Glucose and HbA1c- Based on Adults Except for Known Diabetes
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Kwon Se-Young
Ra Young-Ak
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Abstract
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Among the commonly known tools to diagnose diabetes are fasting plasma glucose (FPG), HbA1c., and OGTT known as gold standard. However, there can be many disagreements on the ways to diagnose diabetes. In this study, we examined the differences of the types of diabetes according to the applicability of FPG and HbA1c. Moreover, we evaluated the concordance of diagnosis. We excluded subjects with missing glucose and HbA1c data, as well as those previously diagnosed with diabetes, and those who fasted less than 8 hours. The data of 4,502 subjects (1,956 men and 2,546 women) from the 2015 KNHNES were analyzed. We divided these patients into three categories which are normal, prediabetes, and diabetes, based on the FPG and HbA1c. In men, the number of subjects with FPG ranging from 100 to 125 mg/dL and HbA1c ≥6.5% was 23 out of 664, and the number of subjects with FPG <126 mg/dL and HbA1c ≥6.5% was 39 out of 86 newly diagnosed diabetes patients. The concordance rate was as follows: Normal 80.3%, prediabetes 44.9%, and diabetes 54.7%. The coefficient of Cohen’s Kappa was 0.322 in men and 0.362 in women; this suggests that both gender showed a low concordance rate. However, when we divided them into two categories (nondiabetes and diabetes), Kappa was 0.582 in men and 0.637 in women, showing a relatively high concordance rate. While all subjects with FPG ≥126 mg/dL showed a significantly high HOMA IR, all subjects with FPG <126 mg/dL showed a significantly high QUICKI. Considering the low concordance rate for the diagnosis of diabetes and characteristic of diagnostic tests, it is necessary to combine the related tests for diagnosing diabetes.
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KEYWORD
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Fasting plasma glucose, HbA1c, Newly diagnosed diabetes
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