Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea
BackgroundWe performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea.MethodsWe retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women)...
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| Format: | Article |
| Language: | English |
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Korean Diabetes Association
2012-04-01
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| Series: | Diabetes & Metabolism Journal |
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| Online Access: | http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-36-151.pdf |
| _version_ | 1818051158668738560 |
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| author | Hong-Kyu Kim Sung-Jin Bae Jaeone Choe |
| author_facet | Hong-Kyu Kim Sung-Jin Bae Jaeone Choe |
| author_sort | Hong-Kyu Kim |
| collection | DOAJ |
| description | BackgroundWe performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea.MethodsWe retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women) which were measured during regular health check-ups. After excluding subjects with previously diagnosed diabetes mellitus (n=1,812) and with overt anemia (n=318), 35,624 subjects (21,201 men and 14,423 women) were included in the analysis.ResultsAmong the 35,624 subjects, 11,316 (31.8%) subjects were categorized as increased risk for diabetes (IRD) by fasting plasma glucose (FPG) criteria, 6,531 (18.1%) subjects by HbA1c criteria, and 13,556 (38.1%) subjects by combined criteria. Therefore, although HbA1c criteria alone identifies 42% [(11,316-6,531)/11,316] fewer subjects with IRD than does FPG criteria, about 20% [(13,556-11,316)/11,316] more subjects could be detected by including new HbA1c criteria in addition to FPG criteria. Among the 13,556 subjects with IRD, 7,025 (51.8%) met FPG criteria only, 2,240 (16.5%) met HbA1c criteria only, and 4,291 (31.7%) met both criteria. Among subjects with impaired fasting glucose, 65% were normal, 32% were IRD, and 3% were diabetes by HbA1c criterion. In receiver operating characteristic curve analysis, cutoff point of HbA1c with optimal sensitivity and specificity for identifying IRD was 5.4%.ConclusionAlthough HbA1c criteria alone identifies fewer subjects with IRD than does FPG criteria, about 20% more could be detected by addition of HbA1c criteria. Further studies are needed to define optimal cutoff point of HbA1c and to establish screening and management guidelines for IRD. |
| first_indexed | 2024-12-10T11:04:55Z |
| format | Article |
| id | doaj.art-7f8d91b6d18e48a4ad3199cf6066093f |
| institution | Directory Open Access Journal |
| issn | 2233-6079 2233-6087 |
| language | English |
| last_indexed | 2024-12-10T11:04:55Z |
| publishDate | 2012-04-01 |
| publisher | Korean Diabetes Association |
| record_format | Article |
| series | Diabetes & Metabolism Journal |
| spelling | doaj.art-7f8d91b6d18e48a4ad3199cf6066093f2022-12-22T01:51:36ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872012-04-0136215115610.4093/dmj.2012.36.2.1512460Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in KoreaHong-Kyu KimSung-Jin BaeJaeone ChoeBackgroundWe performed the study to examine the impact of hemoglobin A1c (HbA1c) criterion on the screening of increased risk for diabetes among health check-up subjects in Korea.MethodsWe retrospectively analyzed clinical and laboratory data of 37,754 Korean adults (age, 20 to 89 years; 41% women) which were measured during regular health check-ups. After excluding subjects with previously diagnosed diabetes mellitus (n=1,812) and with overt anemia (n=318), 35,624 subjects (21,201 men and 14,423 women) were included in the analysis.ResultsAmong the 35,624 subjects, 11,316 (31.8%) subjects were categorized as increased risk for diabetes (IRD) by fasting plasma glucose (FPG) criteria, 6,531 (18.1%) subjects by HbA1c criteria, and 13,556 (38.1%) subjects by combined criteria. Therefore, although HbA1c criteria alone identifies 42% [(11,316-6,531)/11,316] fewer subjects with IRD than does FPG criteria, about 20% [(13,556-11,316)/11,316] more subjects could be detected by including new HbA1c criteria in addition to FPG criteria. Among the 13,556 subjects with IRD, 7,025 (51.8%) met FPG criteria only, 2,240 (16.5%) met HbA1c criteria only, and 4,291 (31.7%) met both criteria. Among subjects with impaired fasting glucose, 65% were normal, 32% were IRD, and 3% were diabetes by HbA1c criterion. In receiver operating characteristic curve analysis, cutoff point of HbA1c with optimal sensitivity and specificity for identifying IRD was 5.4%.ConclusionAlthough HbA1c criteria alone identifies fewer subjects with IRD than does FPG criteria, about 20% more could be detected by addition of HbA1c criteria. Further studies are needed to define optimal cutoff point of HbA1c and to establish screening and management guidelines for IRD.http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-36-151.pdfFasting plasma glucoseHemoglobin A, glycosylatedPrediabetic statePrevalence |
| spellingShingle | Hong-Kyu Kim Sung-Jin Bae Jaeone Choe Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea Diabetes & Metabolism Journal Fasting plasma glucose Hemoglobin A, glycosylated Prediabetic state Prevalence |
| title | Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea |
| title_full | Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea |
| title_fullStr | Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea |
| title_full_unstemmed | Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea |
| title_short | Impact of HbA1c Criterion on the Detection of Subjects with Increased Risk for Diabetes among Health Check-Up Recipients in Korea |
| title_sort | impact of hba1c criterion on the detection of subjects with increased risk for diabetes among health check up recipients in korea |
| topic | Fasting plasma glucose Hemoglobin A, glycosylated Prediabetic state Prevalence |
| url | http://e-dmj.org/Synapse/Data/PDFData/2004DMJ/dmj-36-151.pdf |
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