| Autor: |
Chivese, Tawanda, Hirst, Jennifer, Matizanadzo, Joshua T., Custodio, Michael, Farmer, Andrew, Norris, Shane, Levitt, Naomi |
| Předmět: |
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| Zdroj: |
Diabetic Medicine; Apr2022, Vol. 39 Issue 4, p1-13, 13p |
| Abstrakt: |
Objective: To assess the diagnostic accuracy of glycated haemoglobin A1c (HbA1c), compared to fasting plasma glucose (FPG) and the oral glucose tolerance test (OGTT), in screening for type 2 diabetes (T2D) in Africa. Methods: We systematically searched databases for studies that compared the HbA1c to either the OGTT, or the FPG for T2D diagnosis were included. The QUADAS 2 tool was used for assessing the quality of included studies. We used the split component synthesis (SCS) method for the meta‐analysis of diagnostic accuracy studies to pool the studies for meta‐analysis of sensitivity and specificity, primarily at the HbA1c ≥48 mmol/mol (6.5%) cut‐off and at other cut‐offs. We assessed heterogeneity using the I2 statistic and publication bias using Doi plots. Results: Eleven studies, from seven African countries, with 12,925 participants, were included. Against the OGTT, HbA1c ≥48 mmol/mol (6.5%) had a pooled sensitivity of 57.7% (95% confidence interval [CI] 43.4–70.9) and specificity of 92.3% (95% CI 83.9–96.5). Against the FPG, HbA1c ≥48 mmol/mol (6.5%) had a pooled sensitivity of 64.5% (95% CI 50.5–76.4) and specificity of 94.3% (95% CI 87.9–97.5). The highest sensitivity for HbA1c, against the OGTT, was at the 42 mmol/mol (6.0%) cut‐off. Conclusion: In Africa, the HbA1c ≥48 mmol/mol (6.5%) cut‐off may miss almost half of the individuals with T2D based on blood glucose measures. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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