|
KMID : 0384320110320070383
|
|
Korean Journal of Family Medicine
2011 Volume.32 No. 7 p.383 ~ p.389
|
|
|
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
|
|
|
Abstract
|
|
|
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 defi ned 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 specifi city 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%; specifi city, 88.2%; area under the curve, 0.85). HbA1c was signifi cantly 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.
|
|
|
KEYWORD
|
|
|
Diabetes, Hemoglobin A, Glycosylated, Diagnosis, Glucose Tolerance Test
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|