The usefulness of glycated hemoglobin A1c (HbA1c) for identifying dysglycemic states in individuals without previously diagnosed diabetes
| Autor: | Adam Kretowski, Joanna Gościk, Edyta Adamska, Katarzyna Maliszewska, Maria Gorska, Lucyna Ostrowska, Danuta Lipinska, Anna Wasilewska, Juliusz Wilk, Magdalena Waszczeniuk, Robert Milewski, Agnieszka Nikolajuk, Anna Golonko, Justyna Pliszka, Anna Citko |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent endocrine system diseases Population Type 2 diabetes Prediabetic State Young Adult Diabetes mellitus Internal medicine Diabetes Mellitus medicine Humans Mass Screening Young adult education False Negative Reactions Mass screening Aged Glycated Hemoglobin Glucose tolerance test education.field_of_study Receiver operating characteristic medicine.diagnostic_test business.industry Reproducibility of Results nutritional and metabolic diseases General Medicine Glucose Tolerance Test Middle Aged medicine.disease Endocrinology Female business |
| Zdroj: | Advances in Medical Sciences. 57:296-301 |
| ISSN: | 1896-1126 |
| DOI: | 10.2478/v10039-012-0030-x |
| Popis: | Purpose We investigated HbA1c's validity as a screening parameter for excluding dysglycemic states in the studied population. Material/Methods Sensitivity and specificity of HbA1c in some cut-off points were compared with diagnoses based on the oral glucose tolerance test (OGTT) in individuals diagnosed between 2009–2010. Receiver operating characteristic (ROC) analysis for HbA1c was conducted. HbA1c and OGGT measures were done in 441 people (253 women, 187 men, average age 40.1 years (18–79 years)). Based on the OGGT test 37 individuals were diagnosed as diabetic, 28 as impaired glucose tolerant (IGT) and 63 as having impaired fasting glycemia (IFG). Results A cut-off value of 6.5% HbA1c classifies diabetic subjects with a sensitivity of 45.9% and specificity of 97.5%. In the investigated population the best cut-off point (the highest sum of the sensitivity and specificity) was 5.9% HbA1c (sensitivity 86.6%, specificity 73%). HbA1c values excluding the risk of dysglycemic states have shown false negative rate in 31.9% when HbA1c was 5.5% and 10.6% when HbA1c was 5.0%. Conclusions Our results indicate that in the investigated population the evaluation of the prevalence of type 2 diabetes using HbA1c values proposed by the American Diabetes Association (ADA) has unsatisfactory sensitivity and detects less than a half of cases of diabetes based on the OGTT diagnoses. HbA1c 5.7% does not have sufficient specificity to identify individuals not being at risk of any disorder of glucose metabolism. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect