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Comparison of the performance of HbA1c and fasting plasma glucose in identifying dysglycaemic status in Chinese high-risk subjects.
Clin Exp Pharmacol Physiol. 2013 Feb; 40(2):63-8.CE

Abstract

The aim of the present study was to compare the performance of HbA1c and fasting plasma glucose (FPG) in identifying dysglycaemic status among Chinese participants. Fasting plasma glucose and HbA1c were measured in 2318 subjects with at least one risk factor for diabetes but without being previously diagnosed with diabetes. Using HbA1c to diagnose diabetes resulted in the same classification as FPG for 90.5% of the study participants, with 21.0% (n = 487) classified as having diabetes by both FPG and HbA1c and 69.5% (n = 1610) classified as not having diabetes by both FPG and HbA1c. The kappa (κ) coefficient of the FPG criterion with the HbA1c criterion for diabetes was 0.75 (95% confidence interval (CI) 0.72-0.78). The overlap index regarding diabetes diagnosed by FPG or HbA1c was 68.8%. Of 1610 subjects with FPG < 126 mg/dL and HbA1c < 6.5%, 220 (13.7%) had FPG ≥ 100 mg/dL and HbA1c < 5.7%, whereas 277 (17.2%) had FPG < 100 mg/dL and HbA1c ≥ 5.7%. The κ coefficient of the FPG criterion with the HbA1c criterion for prediabetes was 0.30 (95% CI 0.25-0.35). The overlap index between subjects diagnosed as having prediabetes by FPG of 100-125 mg/dL (impaired fasting glucose (IFG)) or HbA1c of 5.7-6.4% (increased HbA1c (IGH)) was 35.9%. The HbA1c criterion demonstrates reasonable concordance with the FPG criterion for diabetes. Hence, HbA1c and FPG can be used for the diagnosis of diabetes. However, the IGH shows limited overlap with IFG for prediabetes. Introduction of the IGH criterion in addition to IFG for the screening of prediabetes could lead to the identification of more people with this condition.

Authors+Show Affiliations

Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23198814

Citation

Du, Ting-Ting, et al. "Comparison of the Performance of HbA1c and Fasting Plasma Glucose in Identifying Dysglycaemic Status in Chinese High-risk Subjects." Clinical and Experimental Pharmacology & Physiology, vol. 40, no. 2, 2013, pp. 63-8.
Du TT, Yin P, Zhang JH, et al. Comparison of the performance of HbA1c and fasting plasma glucose in identifying dysglycaemic status in Chinese high-risk subjects. Clin Exp Pharmacol Physiol. 2013;40(2):63-8.
Du, T. T., Yin, P., Zhang, J. H., Zhang, D., Shi, W., & Yu, X. F. (2013). Comparison of the performance of HbA1c and fasting plasma glucose in identifying dysglycaemic status in Chinese high-risk subjects. Clinical and Experimental Pharmacology & Physiology, 40(2), 63-8. https://doi.org/10.1111/1440-1681.12038
Du TT, et al. Comparison of the Performance of HbA1c and Fasting Plasma Glucose in Identifying Dysglycaemic Status in Chinese High-risk Subjects. Clin Exp Pharmacol Physiol. 2013;40(2):63-8. PubMed PMID: 23198814.
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TY - JOUR T1 - Comparison of the performance of HbA1c and fasting plasma glucose in identifying dysglycaemic status in Chinese high-risk subjects. AU - Du,Ting-Ting, AU - Yin,Ping, AU - Zhang,Jian-Hua, AU - Zhang,Dan, AU - Shi,Wei, AU - Yu,Xue-Feng, PY - 2012/05/02/received PY - 2012/11/25/revised PY - 2012/11/26/accepted PY - 2012/12/4/entrez PY - 2012/12/4/pubmed PY - 2013/10/18/medline SP - 63 EP - 8 JF - Clinical and experimental pharmacology & physiology JO - Clin Exp Pharmacol Physiol VL - 40 IS - 2 N2 - The aim of the present study was to compare the performance of HbA1c and fasting plasma glucose (FPG) in identifying dysglycaemic status among Chinese participants. Fasting plasma glucose and HbA1c were measured in 2318 subjects with at least one risk factor for diabetes but without being previously diagnosed with diabetes. Using HbA1c to diagnose diabetes resulted in the same classification as FPG for 90.5% of the study participants, with 21.0% (n = 487) classified as having diabetes by both FPG and HbA1c and 69.5% (n = 1610) classified as not having diabetes by both FPG and HbA1c. The kappa (κ) coefficient of the FPG criterion with the HbA1c criterion for diabetes was 0.75 (95% confidence interval (CI) 0.72-0.78). The overlap index regarding diabetes diagnosed by FPG or HbA1c was 68.8%. Of 1610 subjects with FPG < 126 mg/dL and HbA1c < 6.5%, 220 (13.7%) had FPG ≥ 100 mg/dL and HbA1c < 5.7%, whereas 277 (17.2%) had FPG < 100 mg/dL and HbA1c ≥ 5.7%. The κ coefficient of the FPG criterion with the HbA1c criterion for prediabetes was 0.30 (95% CI 0.25-0.35). The overlap index between subjects diagnosed as having prediabetes by FPG of 100-125 mg/dL (impaired fasting glucose (IFG)) or HbA1c of 5.7-6.4% (increased HbA1c (IGH)) was 35.9%. The HbA1c criterion demonstrates reasonable concordance with the FPG criterion for diabetes. Hence, HbA1c and FPG can be used for the diagnosis of diabetes. However, the IGH shows limited overlap with IFG for prediabetes. Introduction of the IGH criterion in addition to IFG for the screening of prediabetes could lead to the identification of more people with this condition. SN - 1440-1681 UR - https://www.unboundmedicine.com/medline/citation/23198814/Comparison_of_the_performance_of_HbA1c_and_fasting_plasma_glucose_in_identifying_dysglycaemic_status_in_Chinese_high_risk_subjects_ DB - PRIME DP - Unbound Medicine ER -