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Glycated haemoglobin A1c for diagnosing diabetes in Chinese population: cross sectional epidemiological survey.

Authors :
Bao Y
Ma X
Li H
Zhou M
Hu C
Wu H
Tang J
Hou X
Xiang K
Jia W
Source :
BMJ (Clinical research ed.) [BMJ] 2010 May 17; Vol. 340, pp. c2249. Date of Electronic Publication: 2010 May 17.
Publication Year :
2010

Abstract

Objectives: To evaluate haemoglobin A1c (HbA(1c)) in diagnosing diabetes and identify the optimal HbA(1c) threshold to be used in Chinese adults.<br />Design: Multistage stratified cross sectional epidemiological survey.<br />Setting: Shanghai, China, 2007-8.<br />Participants: 4886 Chinese adults over 20 years of age with no history of diabetes.<br />Main Outcome Measures: Performance of HbA(1c) at increasing thresholds for diagnosing diabetes.<br />Results: The area under the receiver operating characteristics curve for detecting undiagnosed diabetes was 0.856 (95% confidence interval 0.828 to 0.883) for HbA(1c) alone and 0.920 (0.900 to 0.941) for fasting plasma glucose alone. Very high specificity (96.1%, 95% confidence interval 95.5% to 96.7%) was achieved at an HbA(1c) threshold of 6.3% (2 SD above the normal mean). Moreover, the corresponding sensitivity was 62.8% (57.1% to 68.3%), which was equivalent to that of a fasting plasma glucose threshold of 7.0 mmol/l (57.5%, 51.7% to 63.1%) in detecting undiagnosed diabetes. In participants at high risk of diabetes, the HbA(1c) threshold of 6.3% showed significantly higher sensitivity (66.9%, 61.0% to 72.5%) than both fasting plasma glucose >or=7.0 mmol/l (54.4%, 48.3% to 60.4%) and HbA(1c) >or=6.5% (53.7%, 47.6% to 59.7%) (P<0.01).<br />Conclusions: An HbA(1c) threshold of 6.3% was highly specific for detecting undiagnosed diabetes in Chinese adults and had sensitivity similar to that of using a fasting plasma glucose threshold of 7.0 mmol/l. This optimal HbA(1c) threshold may be suitable as a diagnostic criterion for diabetes in Chinese adults when fasting plasma glucose and oral glucose tolerance tests are not available.

Details

Language :
English
ISSN :
1756-1833
Volume :
340
Database :
MEDLINE
Journal :
BMJ (Clinical research ed.)
Publication Type :
Academic Journal
Accession number :
20478961
Full Text :
https://doi.org/10.1136/bmj.c2249