Diabetes Metab J.  2012 Feb;36(1):37-42. 10.4093/dmj.2012.36.1.37.

Role of HbA1c in the Screening of Diabetes Mellitus in a Korean Rural Community

• Kim JH
• Kim GW
• Lee MY
• Shin JY
• Shin YG
• Koh SB
• Chung CH

• KMID: 2281427
• DOI: http://doi.org/10.4093/dmj.2012.36.1.37

Abstract

BACKGROUND
Recently, the measurement of glycated hemoglobin (HbA1c) was recommended as an alternative to fasting plasma glucose or oral glucose tolerance tests for diagnosing diabetes mellitus (DM). In this study, we analyzed HbA1c levels for diabetes mellitus screening in a Korean rural population.
METHODS
We analyzed data from 10,111 subjects from a Korean Rural Genomic Cohort study and generated a receiver operating characteristic curve to determine an appropriate HbA1c cutoff value for diabetes.
RESULTS
The mean age of the subjects was 56.3+/-8.1 years. Fasting plasma glucose and 2-hour plasma glucose after 75 g oral glucose tolerance tests were 97.5+/-25.6 and 138.3+/-67.1 mg/dL, respectively. The mean HbA1c level of the subjects was 5.7+/-0.9%. There were 8,809 non-DM patients (87.1%) and 1,302 DM patients (12.9%). A positive relationship between HbA1c and plasma glucose levels and between HbA1c and 2-hour plasma glucose levels after oral glucose tolerance tests was found in a scatter plot of the data. Using Youden's index, the proper cutoff level of HbA1c for diabetes mellitus screening was 5.95% (sensitivity, 77%; specificity, 89.4%).
CONCLUSION
Our results suggest that the optimal HbA1c level for DM screening is 5.95%.

Keyword

Diabetes mellitus; Diagnosis; Hemoglobin A, glycosylated; Screening

MeSH Terms

Cohort Studies
Diabetes Mellitus
Fasting
Glucose
Glucose Tolerance Test
Hemoglobin A, Glycosylated
Hemoglobins
Humans
Mass Screening
Plasma
ROC Curve
Rural Population
Sensitivity and Specificity
Glucose
Hemoglobin A, Glycosylated
Hemoglobins

Figure

• 

  Fig. 1 (A) Scatter plot of individuals according to HbA1c and fasting plasma glucose level (correlation coefficient, 0.51; P=0.00) (B) Scatter plot of individuals according to HbA1c and 2-hour plasma glucose level after oral glucose tolerance tests (correlation coefficient, 0.33; P=0.00). Glu_FBS, fasting blood glucose; Glu_PP120, postprandial blood glucose after 120 minutes.

• 

  Fig. 2 Receiver operating characteristic curves for HbA1c corresponding diabetes mellitus defined by Korean Diabetes Association (use Youden's index).

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