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HbA1c Cutoff Point of 5.9% Better Identifies High Risk of Progression to Diabetes among Chinese Adults: Results from a Retrospective Cohort Study.
Liang, Kai; Wang, Chuan; Yan, Fei; Wang, Lingshu; He, Tianyi; Zhang, Xiuping; Li, Chengqiao; Yang, Weifang; Ma, Zeqiang; Ma, Aixia; Hou, Xinguo; Chen, Li.
Afiliación
  • Liang K; Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China.
  • Wang C; Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China.
  • Yan F; Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China.
  • Wang L; Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China.
  • He T; Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China.
  • Zhang X; Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China.
  • Li C; Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China.
  • Yang W; Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China.
  • Ma Z; Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China.
  • Ma A; Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China.
  • Hou X; Institute of Endocrinology and Metabolism Disease, Shandong University, Jinan, China.
  • Chen L; Key Laboratory of Endocrinology and Metabolism Disease, Shandong Province Medicine & Health, Jinan, China.
J Diabetes Res ; 2018: 7486493, 2018.
Article en En | MEDLINE | ID: mdl-30009184
AIMS: This article performed a retrospective cohort study to estimate the annual incidence rates of diabetes and to assess the utility of HbA1c as a predictor for progression to diabetes in Chinese community adults aged 40 years or older. METHODS: In all, 2778 nondiabetic subjects (including 1901 women) underwent HbA1c testing and oral glucose tolerance test (OGTT) measurements at baseline and after 3 years. Diabetes and prediabetes were defined using the WHO criteria. The HbA1c cutoff points were evaluated to predict the future risks of diabetes. Relative risk (RR) was calculated using the chi-square test. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive efficiency of fasting plasma glucose (FPG), 2 hr postprandial plasma glucose (2hPG), and HbA1c for progression to diabetes. A superior cutoff point was defined as the point on the ROC curve with a larger Youden index. RESULTS: Overall, 7.5% (210/2778) of the subjects progressed to diabetes, yielding an annual 2.5% diabetes incidence rate. Additionally, 4.5% (100/2227) of the subjects with normal glucose tolerance (NGT) and 19.6% (110/561) of the subjects with prediabetes progressed to diabetes, and the relative risk of progression to diabetes was 5.188 times higher in subjects with prediabetes than in subjects with NGT (p < 0.001). Compared to subjects with HbA1c values ≤ 5.6%, the RRs of progression to diabetes in subjects whose HbA1c ranged from 5.7 to 5.8%, 5.9 to 6.2%, 6.3 to 6.4%, and ≥6.5% were 1.165, 2.582, 5.732, and 16.619, respectively. However, the RRs for subjects with HbA1c ranging from 5.7 to 5.8% and those with HbA1c ≤ 5.6% did not differ significantly (p = 0.615). The AUCs for predicting diabetes after 3 years by FPG, 2hPG, and HbA1c were 0.752 (95% confidence interval 0.718-0.787), 0.710 (95% confidence interval 0.671-0.748), and 0.756 (95% confidence interval 0.720-0.793), respectively. The HbA1c cutoff point of 5.9% (sensitivity of 0.771 and specificity of 0.580) may better identify individuals at high risk of progression to diabetes than the 5.7% value (sensitivity of 0.862 and specificity of 0.371) due to the former's larger Youden index of 0.351, which exceeded the indices for FPG and 2hPG. CONCLUSIONS: The use of HbA1c values ≥ 5.9% may provide greater accuracy in evaluating the risk of progression to diabetes and identify individuals with prediabetes with greater reliability among Chinese adults.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemoglobina Glucada / Diabetes Mellitus Tipo 2 Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Diabetes Res Año: 2018 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemoglobina Glucada / Diabetes Mellitus Tipo 2 Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Diabetes Res Año: 2018 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido