Combining glycosylated hemoglobin A1c and fasting plasma glucose for diagnosis of type 2 diabetes in Chinese adults

BMC Endocrine Disorders

Wang-Hong Xu²  Rui Li³  Qingwu Jiang²  Yanyun Li³  Qundi Yang³  Dajiang Lu¹  Liang Shi³  Hua Zhang²  Ye Ruan³  Genming Zhao²  Weijian Zhong³  Miao Mo² 

[1] School of Sports Science, Shanghai University of Sport, 399 Chang Hai Road, Shanghai 200438, People’s Republic of China;Department of Epidemiology, School of Public Health; Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, People’s Republic of China;Shanghai Municipal Center for Disease Control and Prevention, 1380 Zhong Shan Xi Road, Shanghai 200336, People’s Republic of China

关键词: Chinese adults;    Fasting plasma glucose;    Glycosylated hemoglobin A_1c;    Diagnosis;    Type 2 diabetes;   

Others  :  1085597
DOI  :  10.1186/1472-6823-13-44

 received in 2013-03-28, accepted in 2013-09-30,  发布年份 2013

【 摘 要 】

Background

Glycosylated hemoglobin A_1c (HbA_1c) has been applied to identify type 2 diabetes (T2DM) in the U.S. and European countries. It has not been used in China mainly due to lack of a standardized approach to measure HbA_1c, short of knowledge about racial-specific standard and deficiency of an optimal cut-off point.

Methods

To evaluate combination of HbA_1c and fasting plasma glucose (FPG) in diagnosing T2DM in Chinese adults, a multistage sampling cross-sectional study was conducted in Shanghai, China, in 2009. The FPG measurement, HbA_1c assay, and oral glucose tolerance test (OGTT) were performed in 6,661 Chinese adults (3057 men, 3604 women) who had no prior history of diabetes to identify the unrecognized T2DM.

Results

A total of 454 participants were identified as T2DM based on the 1999 World Health Organization (WHO) diagnostic criteria. Of these patients, 239 were detected using an FPG ≥ 7.0 mmol/l and 141 were further identified using an HbA_1c ≥ 43 mmol/mol (6.1%), achieving a sensitivity of 83.7% and a specificity of 89.3% for combining use of FPG and HbA_1c. In subjects at high risk of diabetes, the combining use of FPG and HbA_1c produced a higher sensitivity and an improved positive predictive value (PPV), and had a satisfactory specificity and negative predictive value (NPV).

Conclusions

The combining use of FPG and HbA_1c is a potential screening and diagnosis approach for T2DM in Chinese adults, especially among those at high risk of the disease.

【 授权许可】

   
2013 Mo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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