Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes
Abstract Introduction People with a low or high haemoglobin glycation index (HGI) have lower or higher HbA1c than other people with the same FPG. This study compared the prevalence of prediabetes based on FPG, 2hOGTT and HbA1c in people with low, moderate or high HGI. Methods Prediabetes was diagnos...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Endocrinology, Diabetes & Metabolism |
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| Online Access: | https://doi.org/10.1002/edm2.442 |
| _version_ | 1797688399635677184 |
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| author | James M. Hempe Shengping Yang Daniel S. Hsia |
| author_facet | James M. Hempe Shengping Yang Daniel S. Hsia |
| author_sort | James M. Hempe |
| collection | DOAJ |
| description | Abstract Introduction People with a low or high haemoglobin glycation index (HGI) have lower or higher HbA1c than other people with the same FPG. This study compared the prevalence of prediabetes based on FPG, 2hOGTT and HbA1c in people with low, moderate or high HGI. Methods Prediabetes was diagnosed based on ADA cutpoints in 10,488 NHANES participants without self‐reported diabetes. HGI was calculated as the difference between a participant's observed HbA1c and a predicted HbA1c where predicted HbA1c = 0.024 FPG + 3.1. Participants were divided into low (HGI < −0.15%), moderate (HGI −0.15% to +0.15%) and high (HGI > +0.15%) HGI subgroups. Results The prevalence of prediabetes was 42.4% based on FPG, 27.2% based on HbA1c and 17.2% based on 2hOGTT. FPG and HbA1c thus overdiagnosed prediabetes by 25.2% and 10.0%, respectively, compared to the OGTT gold standard. Prevalence was (1) similar in low, moderate and high HGI participants based on 2hOGTT, (2) highest in low HGI participants based on FPG, and (3) highest in high HGI participants based on HbA1c. Among participants with mismatched FPG and HbA1c, OGTT was normal in (1) 79.5% of participants with normal FPG but prediabetic HbA1c (mean HGI = +0.53%), and (2) 75.2% of participants with normal HbA1c but prediabetic FPG (mean HGI = −0.30%). Conclusions FPG overdiagnosed prediabetes in people with low HGI. HbA1c overdiagnosed prediabetes in people with high HGI. Clinical use of HGI could improve prediabetes diagnosis and help health care providers avoid inappropriate or delayed treatment of people with extremes of HGI. |
| first_indexed | 2024-03-12T01:31:16Z |
| format | Article |
| id | doaj.art-6c4d156df4a04da78b23ce3126aa8327 |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-03-12T01:31:16Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-6c4d156df4a04da78b23ce3126aa83272023-09-12T04:11:08ZengWileyEndocrinology, Diabetes & Metabolism2398-92382023-09-0165n/an/a10.1002/edm2.442Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetesJames M. Hempe0Shengping Yang1Daniel S. Hsia2Department of Pediatrics Louisiana State University Health Sciences Center New Orleans Louisiana USAPennington Biomedical Research Center Baton Rouge Louisiana USAPennington Biomedical Research Center Baton Rouge Louisiana USAAbstract Introduction People with a low or high haemoglobin glycation index (HGI) have lower or higher HbA1c than other people with the same FPG. This study compared the prevalence of prediabetes based on FPG, 2hOGTT and HbA1c in people with low, moderate or high HGI. Methods Prediabetes was diagnosed based on ADA cutpoints in 10,488 NHANES participants without self‐reported diabetes. HGI was calculated as the difference between a participant's observed HbA1c and a predicted HbA1c where predicted HbA1c = 0.024 FPG + 3.1. Participants were divided into low (HGI < −0.15%), moderate (HGI −0.15% to +0.15%) and high (HGI > +0.15%) HGI subgroups. Results The prevalence of prediabetes was 42.4% based on FPG, 27.2% based on HbA1c and 17.2% based on 2hOGTT. FPG and HbA1c thus overdiagnosed prediabetes by 25.2% and 10.0%, respectively, compared to the OGTT gold standard. Prevalence was (1) similar in low, moderate and high HGI participants based on 2hOGTT, (2) highest in low HGI participants based on FPG, and (3) highest in high HGI participants based on HbA1c. Among participants with mismatched FPG and HbA1c, OGTT was normal in (1) 79.5% of participants with normal FPG but prediabetic HbA1c (mean HGI = +0.53%), and (2) 75.2% of participants with normal HbA1c but prediabetic FPG (mean HGI = −0.30%). Conclusions FPG overdiagnosed prediabetes in people with low HGI. HbA1c overdiagnosed prediabetes in people with high HGI. Clinical use of HGI could improve prediabetes diagnosis and help health care providers avoid inappropriate or delayed treatment of people with extremes of HGI.https://doi.org/10.1002/edm2.442blood glucoseglycated haemoglobinhaemoglobin glycation indexprediabetes |
| spellingShingle | James M. Hempe Shengping Yang Daniel S. Hsia Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes Endocrinology, Diabetes & Metabolism blood glucose glycated haemoglobin haemoglobin glycation index prediabetes |
| title | Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes |
| title_full | Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes |
| title_fullStr | Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes |
| title_full_unstemmed | Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes |
| title_short | Effect of biological variation in HbA1c and blood glucose on the diagnosis of prediabetes |
| title_sort | effect of biological variation in hba1c and blood glucose on the diagnosis of prediabetes |
| topic | blood glucose glycated haemoglobin haemoglobin glycation index prediabetes |
| url | https://doi.org/10.1002/edm2.442 |
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