Korean J Intern Med.  2012 Mar;27(1):41-46. 10.3904/kjim.2012.27.1.41.

Validity of Glycated Hemoglobin in Screening and Diagnosing Type 2 Diabetes Mellitus in Chinese Subjects

• Yu Y
• Ouyang XJ
• Lou QL
• Gu LB
• Mo YZ
• Ko GT
• Chow CC
• So WY
• Ma R
• Kong A
• Brown N
• Nan J
• Chan J
• Bian RW

• KMID: 1776564
• DOI: http://doi.org/10.3904/kjim.2012.27.1.41

Abstract

BACKGROUND/AIMS
The application of glycated hemoglobin (HbA1c) for the diagnosis of diabetes is currently under extensive discussion. In this study, we explored the validity of using HbA1c as a screening and diagnostic test in Chinese subjects recruited in Nanjing, China.
METHODS
In total, 497 subjects (361 men and 136 women) with fasting plasma glucose (PG) > or = 5.6 mmol/L were recruited to undergo the oral glucose tolerance test (OGTT) and HbA1c test. Plasma lipid, uric acid, and blood pressure were also measured.
RESULTS
Using a receiver operating characteristic curve, the optimal cutoff point of HbA1c related to diabetes diagnosed by the OGTT was 6.3%, with a sensitivity and specificity of 79.6% and 82.2%, respectively, and the area under the curve was 0.87 (95% confidence interval, 0.83 to 0.92). A HbA1c level of 6.5% had a sensitivity and specificity of 62.7% and 93.5%, respectively. When comparing the HbA1c > or = 6.5% or OGTT methods for diagnosing diabetes, the former group had significantly higher HbA1c levels and lower levels of fasting and 2-hour PG than the latter group. No significant difference was observed in the other metabolism indexes between the two groups.
CONCLUSIONS
Our results suggest that HbA1c > or = 6.5% has reasonably good specificity for diagnosing diabetes in Chinese subjects, which is in concordance with the American Diabetes Association recommendations.

Keyword

Glycated hemoglobin; Glucose tolerance test; Diagnosis; Diabetes mellitus, type 2

MeSH Terms

Aged
Analysis of Variance
*Asian Continental Ancestry Group
Biological Markers/blood
Blood Glucose/analysis
China/epidemiology
*Chromatography, High Pressure Liquid/standards
*Chromatography, Ion Exchange/standards
Diabetes Mellitus, Type 2/blood/*diagnosis/ethnology
Fasting/blood
Female
Glucose Tolerance Test/standards
Hemoglobin A, Glycosylated/*analysis
Humans
Male
Mass Screening/*methods/standards
Middle Aged
Predictive Value of Tests
ROC Curve
Reference Standards
Reproducibility of Results
Sensitivity and Specificity