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Implications of the Hemoglobin Glycation Index on the Diagnosis of Prediabetes and Diabetes
- Source :
- The Journal of Clinical Endocrinology & Metabolism. 105:e130-e138
- Publication Year :
- 2020
- Publisher :
- The Endocrine Society, 2020.
-
Abstract
- Objective Fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG) from a 75-g oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) can lead to different results when diagnosing prediabetes and diabetes. The Hemoglobin Glycation Index (HGI) quantifies the interindividual variation in glycation resulting in discrepancies between FPG and HbA1c. We used data from the Vitamin D and Type 2 Diabetes (D2d) study to calculate HGI, to identify HGI-associated variables, and to determine how HGI affects prediabetes and diabetes diagnosis. Measurements A linear regression equation [HbA1c (%) = 0.0164 × FPG (mg/dL) + 4.2] was derived using the screening cohort (n = 6829) and applied to calculate predicted HbA1c. This was subtracted from the observed HbA1c to determine HGI in the baseline cohort with 2hPG data (n = 3945). Baseline variables plus prediabetes and diabetes diagnosis by FPG, HbA1c, and 2hPG were compared among low, moderate, and high HGI subgroups. Results The proportion of women and Black/African American individuals increased from low to high HGI subgroups. Mean FPG decreased and mean HbA1c increased from low to high HGI subgroups, consistent with the HGI calculation; however, mean 2hPG was not significantly different among HGI subgroups. Conclusions High HGI was associated with Black race and female sex as reported previously. The observation that 2hPG was not different across HGI subgroups suggests that variation in postprandial glucose is not a significant source of population variation in HGI. Exclusive use of HbA1c for diagnosis will classify more Black individuals and women as having prediabetes compared with using FPG or 2hPG.
- Subjects :
- medicine.medical_specialty
endocrine system diseases
Endocrinology, Diabetes and Metabolism
Clinical Biochemistry
030209 endocrinology & metabolism
Type 2 diabetes
Biochemistry
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Endocrinology
Glycation
Diabetes mellitus
Internal medicine
medicine
030212 general & internal medicine
Prediabetes
business.industry
Biochemistry (medical)
nutritional and metabolic diseases
medicine.disease
Postprandial
chemistry
Cohort
Hemoglobin
Glycated hemoglobin
business
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 105
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi...........33bb8ecd45574c7184150086d88688eb