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KMID : 1199120090330040306
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Korean Diabetes Journal
2009 Volume.33 No. 4 p.306 ~ p.314
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The Combination of Fasting Plasma Glucose and Glycosylated Hemoglobin as a Predictor for Type 2 Diabetes in Korean Adults
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Lee Chan-Hee
Chun Kyung-Ah
Cho Ihn-Ho
Lee Ji-Eun
Lee Hyung-Woo
Yoon Ji-Sung
Moon Jun-Sung
Chang Woo-Jin
Won Kyu-Chang
Chung Hyun-Hee
Kim Hyun-Jung
Park Sang-Hyun
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Abstract
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Background: The oral glucose tolerance test (OGTT) for detection of diabetes is difficult to perform in clinical settings. The aim of this study is to evaluate the performance of a more practical detection test, combined fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), as a predictor of diabetes mellitus (DM) in a Korean sample.
Methods: We examined 2,045 (M = 1,276, mean age = 47.8 ± 9.0 yrs) medical check-up program participants between January 2002 to December 2003. FPG, HbA1c and a number of other biochemical tests were performed at baseline and four after years after initial screening. Patients who originally presented with diabetes were excluded. The characteristics of newly-diagnosed DM patients and non-diabetic patients were compared.
Results: The incidence of newly diagnosed diabetes was 1.6% (32/2,045) after four years of follow up. The subjects in the DM group were older, had higher levels of SBP, DBP, FPG, HbA1c, triglyceride, HDL cholesterol, GGT and LDH (P < 0.05). In multivariate logistic regression analysis, FPG (odds ratio [OR] 1.124) and HbA1c (OR 4.794) were significantly correlated with onset of diabetes (P < 0.05). The interaction parameter between FPG and HbA1c was more than 1.0, indicating that the two effects are synergistic. The predictive cut-off values of HbA1c and FPG were 5.35% (area under curve [AUC] = 0.944) and 102.5 mg/dL (AUC = 0.930), respectively.
Conclusion: The combination of HbA1c above 5.35% and FPG above 102.5 mg/dL predicted the onset of diabetes in a Korean sample. These results suggest that the combination of FPG and HbA1c may be useful for predicting progression to type 2 diabetes in east Asians.
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KEYWORD
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Blood glucose, Fasting, Glycosylated hemoglobin A, Type 2 diabetes mellitus
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