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Evaluation for fasting and 2-hour glucose and HbA1c for diagnosing diabetes based on prevalence of retinopathy in a Chinese population.
PLoS One. 2012; 7(7):e40610.Plos

Abstract

BACKGROUND

The glycemic thresholds for diabetes diagnosis have long been at the forefront of discussion. However, no information about glycemic cutoff points has been made available for the Chinese population. The aim of the present study was to examine the association of fasting plasma glucose (FPG), 2-h plasma glucose (2-h PG) and HbA(1)c levels with diabetic retinopathy (DR) and determine the associated cutoff levels in a Chinese population.

METHODOLOGY AND PRINCIPAL FINDINGS

In a cross-sectional population-based sample of 2551 Chinese (representing a population of 1,660,500 in a Beijing district) between 18-79 years of age, the three glycemic measures were measured in a 75 g oral glucose tolerance test, and DR was assessed by two 45° color digital retinal images. The prevalence of DR increased in the ninth decile of each variable, corresponding to an FPG of ≥ 7.2 mmol/l, a 2-h PG of ≥ 10.7 mmol/l, and HbA(1)c of ≥ 6.4%, according to the Joinpoint regression method. After excluding individuals receiving antihyperglycemic medication, the prevalence significantly increased at an FPG of ≥ 6.8 mmol/l, a 2-h PG of ≥ 12.0 mmol/l, and HbA(1)c of ≥ 6.7%. The area under the ROC curve for all three measures showed no significant differences for detecting DR. After excluding individuals receiving antihyperglycemic medication, the three measures also showed no significant differences.

CONCLUSIONS AND SIGNIFICANCE

A significant increase in retinopathy prevalence occurs among individuals with FPG ≥ 7.2 mmol/l, 2-h PG ≥ 10.5 mmol/and HbA(1)c ≥ 6.4%; and measuring FPG or HbA(1)c are equally reliable methods as measuring 2-h PG for the diagnosis of diabetes in the Chinese population.

Authors+Show Affiliations

Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22808204

Citation

Xin, Zhong, et al. "Evaluation for Fasting and 2-hour Glucose and HbA1c for Diagnosing Diabetes Based On Prevalence of Retinopathy in a Chinese Population." PloS One, vol. 7, no. 7, 2012, pp. e40610.
Xin Z, Yuan MX, Li HX, et al. Evaluation for fasting and 2-hour glucose and HbA1c for diagnosing diabetes based on prevalence of retinopathy in a Chinese population. PLoS One. 2012;7(7):e40610.
Xin, Z., Yuan, M. X., Li, H. X., Hua, L., Feng, J. P., Shi, J., Zhu, X. R., Cao, X., & Yang, J. K. (2012). Evaluation for fasting and 2-hour glucose and HbA1c for diagnosing diabetes based on prevalence of retinopathy in a Chinese population. PloS One, 7(7), e40610. https://doi.org/10.1371/journal.pone.0040610
Xin Z, et al. Evaluation for Fasting and 2-hour Glucose and HbA1c for Diagnosing Diabetes Based On Prevalence of Retinopathy in a Chinese Population. PLoS One. 2012;7(7):e40610. PubMed PMID: 22808204.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation for fasting and 2-hour glucose and HbA1c for diagnosing diabetes based on prevalence of retinopathy in a Chinese population. AU - Xin,Zhong, AU - Yuan,Ming-Xia, AU - Li,Hong-Xing, AU - Hua,Lin, AU - Feng,Jian-Ping, AU - Shi,Jing, AU - Zhu,Xiao-Rong, AU - Cao,Xi, AU - Yang,Jin-Kui, Y1 - 2012/07/12/ PY - 2012/01/29/received PY - 2012/06/11/accepted PY - 2012/7/19/entrez PY - 2012/7/19/pubmed PY - 2013/1/11/medline SP - e40610 EP - e40610 JF - PloS one JO - PLoS One VL - 7 IS - 7 N2 - BACKGROUND: The glycemic thresholds for diabetes diagnosis have long been at the forefront of discussion. However, no information about glycemic cutoff points has been made available for the Chinese population. The aim of the present study was to examine the association of fasting plasma glucose (FPG), 2-h plasma glucose (2-h PG) and HbA(1)c levels with diabetic retinopathy (DR) and determine the associated cutoff levels in a Chinese population. METHODOLOGY AND PRINCIPAL FINDINGS: In a cross-sectional population-based sample of 2551 Chinese (representing a population of 1,660,500 in a Beijing district) between 18-79 years of age, the three glycemic measures were measured in a 75 g oral glucose tolerance test, and DR was assessed by two 45° color digital retinal images. The prevalence of DR increased in the ninth decile of each variable, corresponding to an FPG of ≥ 7.2 mmol/l, a 2-h PG of ≥ 10.7 mmol/l, and HbA(1)c of ≥ 6.4%, according to the Joinpoint regression method. After excluding individuals receiving antihyperglycemic medication, the prevalence significantly increased at an FPG of ≥ 6.8 mmol/l, a 2-h PG of ≥ 12.0 mmol/l, and HbA(1)c of ≥ 6.7%. The area under the ROC curve for all three measures showed no significant differences for detecting DR. After excluding individuals receiving antihyperglycemic medication, the three measures also showed no significant differences. CONCLUSIONS AND SIGNIFICANCE: A significant increase in retinopathy prevalence occurs among individuals with FPG ≥ 7.2 mmol/l, 2-h PG ≥ 10.5 mmol/and HbA(1)c ≥ 6.4%; and measuring FPG or HbA(1)c are equally reliable methods as measuring 2-h PG for the diagnosis of diabetes in the Chinese population. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/22808204/Evaluation_for_fasting_and_2_hour_glucose_and_HbA1c_for_diagnosing_diabetes_based_on_prevalence_of_retinopathy_in_a_Chinese_population_ L2 - https://dx.plos.org/10.1371/journal.pone.0040610 DB - PRIME DP - Unbound Medicine ER -