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Wang P, Li Y, Wang M, Song L, Dong Y, Han X, Tuomilehto J, Wang Y, Du Y, Qiu C. Comparing glycemic traits in defining diabetes among rural Chinese older adults. PLoS One 2024; 19:e0296694. [PMID: 38271374 PMCID: PMC10810428 DOI: 10.1371/journal.pone.0296694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND We sought to identify the optimal cut-off of glycated hemoglobin (HbA1c) for defining diabetes and to assess the agreements of fasting plasma glucose (FPG), fasting serum glucose (FSG), and HbA1c in defining diabetes among rural older adults in China. METHODS This population-based cross-sectional study included 3547 participants (age ≥61 years, 57.8% women) from the Multidomain Interventions to Delay Dementia and Disability in Rural China from 2018-2019; of these, 3122 had no previously diagnosed diabetes. We identified the optimal cut-off of HbA1c against FPG ≥7.0 mmol/L for defining diabetes by using receiver operating characteristic curve and Youden index. The agreements of FPG, FSG, and HbA1c in defining diabetes were assessed using kappa statistics. RESULTS Among participants without previously diagnosed diabetes (n = 3122), the optimal HbA1c cut-off for defining diabetes was 6.5% (48 mmol/mol), with the sensitivity of 88.9%, specificity of 93.7%, and Youden index of 0.825. The correlation coefficients were 0.845 between FPG and FSG, 0.574 between FPG and HbA1c, and 0.529 between FSG and HbA1c in the total sample (n = 3547). The kappa statistic for defining diabetes was 0.962 between FSG and FPG, and 0.812 between HbA1c and FPG. CONCLUSIONS The optimal cut-off of HbA1c for diagnosing diabetes against FPG >7.0 mmol/L is ≥6.5% in Chinese rural-dwelling older adults. The agreement in defining diabetes using FPG, FSG, and HbA1c is nearly perfect. These results have relevant implications for diabetes research and clinical practice among older adults in China. CLINICAL TRIAL REGISTRATION The protocol of MIND-China was registered in the Chinese Clinical Trial Registry (ChiCTR, www.chictr.org.cn; registration no.: ChiCTR1800017758).
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Affiliation(s)
- Pin Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Yuanjing Li
- Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Mingqi Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Lin Song
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III. Madrid, Spain
- Qingdao Endocrinology and Diabetes Hospital, Qingdao, Shandong Province, P.R. China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Jinan, Shandong Province, P.R. China
- Department of Neurobiology, Aging Research Center, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Wang Y, Wang D, Liang H, He J, Luu SW, Bray CL. Age - a significant independent factor of A1C levels. Evidence from the National Health and Nutrition Examination Survey 1999-2014. Prim Care Diabetes 2020; 14:420-424. [PMID: 31882239 DOI: 10.1016/j.pcd.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/20/2022]
Abstract
AIM The aim of our study is to examine the association between age and A1C levels in nondiabetic subjects and develop the age-adjusted A1C levels for screening and diagnosis of prediabetes and diabetes. METHODS Participants from National Health and Nutrition Examination Survey (NHANES) -1999-2014 with age over 12 years were examined. Individuals with previous diagnosed diabetes, baseline anemia, established hemoglobinopathies, known liver or chronic kidney disease, and abnormal liver function tests or creatinine levels were excluded. Total 16949 subjects consisting of 8651 female subjects and 8298 male subjects were included in the analyses. Linear regression and multivariate regression analyses were performed to assess the relationship between A1C levels and age. Age adjusted A1C levels were determined. RESULTS Significant positive correlation between A1C and age was found in both female and male subjects in the fasting plasma glucose (FPG) interval between 4.4-7mmol/L (80-126mg/dL) (P<0.0001). There was a linear correlation between A1C levels and age. Linear regression analysis suggested A1C levels rose by 0.009% (about 0.09mmol/mol) in female and by 0.008% (about 0.08mmol/mol) in male per year in subjects without abnormality in glucose homeostasis (p<0.0001). CONCLUSIONS Our study concluded that age is a significant independent factor of A1C levels.
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Affiliation(s)
- Yanning Wang
- North Florida Regional Medical Center, Department of Medicine and Graduate Medical Education, Gainesville, FL, United States; University of Central Florida, College of Medicine, Orlando, FL, United States.
| | - Dong Wang
- North Florida Regional Medical Center, Department of Medicine and Graduate Medical Education, Gainesville, FL, United States; University of Central Florida, College of Medicine, Orlando, FL, United States
| | - Hong Liang
- North Florida Regional Medical Center, Department of Medicine and Graduate Medical Education, Gainesville, FL, United States; University of Central Florida, College of Medicine, Orlando, FL, United States
| | - Jing He
- North Florida Regional Medical Center, Department of Medicine and Graduate Medical Education, Gainesville, FL, United States; University of Central Florida, College of Medicine, Orlando, FL, United States
| | - Sue-Wei Luu
- North Florida Regional Medical Center, Department of Medicine and Graduate Medical Education, Gainesville, FL, United States; University of Central Florida, College of Medicine, Orlando, FL, United States
| | - Christopher L Bray
- North Florida Regional Medical Center, Department of Medicine and Graduate Medical Education, Gainesville, FL, United States; University of Central Florida, College of Medicine, Orlando, FL, United States
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Qi J, Su Y, Song Q, Ding Z, Cao M, Cui B, Qi Y. Reconsidering the HbA1c Cutoff for Diabetes Diagnosis Based on a Large Chinese Cohort. Exp Clin Endocrinol Diabetes 2019; 129:86-92. [PMID: 31039601 DOI: 10.1055/a-0833-8119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The HbA1c has been considered as the 'gold standard' in diabetes diagnosis and management, however, age, gender and body mass index (BMI) might have certain effects on HbA1c. We are aiming to further investigate the correlation between age and HbA1c, and whether it was affected by gender and BMI. METHODS A cross-sectional survey including 135,893 nondiabetic individuals who took the physical examination between 2013 and 2017 was conducted. The subjects were grouped by gender, age and BMI, and the interactive and independent effects of the 3 factors on the HbA1c were detected. The median and 95% confidence interval (CI) of HbA1c levels were calculated. RESULTS The HbA1c levels gradually increased along with age, both in female and male, and there is a positive association between BMI and the HbA1c. The difference on HbA1c in gender was associated with both age and BMI, the age-related increase in HbAlc was accentuated in the subgroup with higher BMI, and there was a marked accentuation of the positive association between BMI and HbA1c as age increased. In almost all the young and middle-aged (aged 20-59) subgroups, the 97.5th percentiles of HbA1c levels were lower than 6.5%, suggesting that the single HbA1c cutoff value is probably not applicable to the young and middle-aged population. CONCLUSIONS We recommend that the effects of age, gender and BMI should be taken into consideration when using HbA1c for the diagnosis and management of diabetes, especially in the young and middle-aged population.
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Affiliation(s)
- Jiying Qi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yang Su
- Clinical Laboratory, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Chengdu, China.,Chinese Academy of Sciences, Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Qianqian Song
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhaojun Ding
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Min Cao
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bin Cui
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yan Qi
- Department of Endocrine and Metabolic Diseases, Ruijin Hospital North, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Sex and age affect agreement between fasting plasma glucose and glycosylated hemoglobin for diagnosis of dysglycemia. ENDOCRINOL DIAB NUTR 2017; 64:345-354. [DOI: 10.1016/j.endinu.2017.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/27/2017] [Accepted: 05/29/2017] [Indexed: 11/19/2022]
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Okwechime IO, Roberson S, Odoi A. Prevalence and Predictors of Pre-Diabetes and Diabetes among Adults 18 Years or Older in Florida: A Multinomial Logistic Modeling Approach. PLoS One 2015; 10:e0145781. [PMID: 26714019 PMCID: PMC4699892 DOI: 10.1371/journal.pone.0145781] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 12/08/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Individuals with pre-diabetes and diabetes have increased risks of developing macro-vascular complications including heart disease and stroke; which are the leading causes of death globally. The objective of this study was to estimate the prevalence of pre-diabetes and diabetes, and to investigate their predictors among adults ≥18 years in Florida. METHODS Data covering the time period January-December 2013, were obtained from Florida's Behavioral Risk Factor Surveillance System (BRFSS). Survey design of the study was declared using SVYSET statement of STATA 13.1. Descriptive analyses were performed to estimate the prevalence of pre-diabetes and diabetes. Predictors of pre-diabetes and diabetes were investigated using multinomial logistic regression model. Model goodness-of-fit was evaluated using both the multinomial goodness-of-fit test proposed by Fagerland, Hosmer, and Bofin, as well as, the Hosmer-Lemeshow's goodness of fit test. RESULTS There were approximately 2,983 (7.3%) and 5,189 (12.1%) adults in Florida diagnosed with pre-diabetes and diabetes, respectively. Over half of the study respondents were white, married and over the age of 45 years while 36.4% reported being physically inactive, overweight (36.4%) or obese (26.4%), hypertensive (34.6%), hypercholesteremic (40.3%), and 26% were arthritic. Based on the final multivariable multinomial model, only being overweight (Relative Risk Ratio [RRR] = 1.85, 95% Confidence Interval [95% CI] = 1.41, 2.42), obese (RRR = 3.41, 95% CI = 2.61, 4.45), hypertensive (RRR = 1.69, 95% CI = 1.33, 2.15), hypercholesterolemic (RRR = 1.94, 95% CI = 1.55, 2.43), and arthritic (RRR = 1.24, 95% CI = 1.00, 1.55) had significant associations with pre-diabetes. However, more predictors had significant associations with diabetes and the strengths of associations tended to be higher than for the association with pre-diabetes. For instance, the relative risk ratios for the association between diabetes and being overweight (RRR = 2.00, 95% CI = 1.55, 2.57), or obese (RRR = 4.04, 95% CI = 3.22, 5.07), hypertensive (RRR = 2.66, 95% CI = 2.08, 3.41), hypercholesterolemic (RRR = 1.98, 95% CI = 1.61, 2.45) and arthritic (RRR = 1.28, 95% CI = 1.04, 1.58) were all further away from the null than their associations with pre-diabetes. Moreover, a number of variables such as age, income level, sex, and level of physical activity had significant association with diabetes but not pre-diabetes. The risk of diabetes increased with increasing age, lower income, in males, and with physical inactivity. Insufficient physical activity had no significant association with the risk of diabetes or pre-diabetes. CONCLUSIONS There is evidence of differences in the strength of association of the predictors across levels of diabetes status (pre-diabetes and diabetes) among adults ≥18 years in Florida. It is important to monitor populations at high risk for pre-diabetes and diabetes, so as to help guide health programming decisions and resource allocations to control the condition.
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Affiliation(s)
- Ifechukwude Obiamaka Okwechime
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Shamarial Roberson
- Florida Department of Health, Bureau of Chronic Disease Prevention, Tallahassee, Florida, United States of America
| | - Agricola Odoi
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, United States of America
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Lerner N, Shani M, Vinker S. Predicting type 2 diabetes mellitus using haemoglobin A1c: A community-based historic cohort study. Eur J Gen Pract 2013; 20:100-6. [DOI: 10.3109/13814788.2013.826642] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Hutchinson MS, Joakimsen RM, Njølstad I, Schirmer H, Figenschau Y, Svartberg J, Jorde R. Effects of Age and Sex on Estimated Diabetes Prevalence Using Different Diagnostic Criteria: The Tromsø OGTT Study. Int J Endocrinol 2013; 2013:613475. [PMID: 23365572 PMCID: PMC3556443 DOI: 10.1155/2013/613475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/04/2012] [Accepted: 12/05/2012] [Indexed: 12/30/2022] Open
Abstract
HbA(1c) 6.5% has recently been recommended as an alternative diagnostic criterion for diabetes. The aims of the study were to evaluate the effects of age, sex, and other factors on prevalence of diabetes and to compare risk profiles of subjects with diabetes when defined by HbA(1c) and glucose criteria. Subjects were recruited among participants in the longitudinal population-based Tromsø Study. HbA(1c), fasting plasma glucose, and 2-hour plasma glucose were measured in 3,476 subjects. In total, 294 subjects met one or more of the diagnostic criteria for diabetes; 95 met the HbA(1c) criterion only, 130 met the glucose criteria only, and 69 met both. Among subjects with diabetes detected by glucose criteria (regardless of HbA(1c)), isolated raised 2-hour plasma glucose was more common in subjects aged ≥ 60 years as compared to younger subjects and in elderly women as compared to elderly men. Subjects with diabetes detected by glucose criteria only had worse cardiometabolic risk profiles than those detected by HbA(1c) only. In conclusion, the current HbA(1c) and glucose criteria defined different subjects with diabetes with only modest overlap. Among a substantial proportion of elderly subjects, and especially elderly women, the 2-hour plasma glucose was the only abnormal value.
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Affiliation(s)
- Moira Strand Hutchinson
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
- *Moira Strand Hutchinson:
| | - Ragnar Martin Joakimsen
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway
| | - Henrik Schirmer
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Yngve Figenschau
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
- Department of Medical Biology, University of Tromsø, 9037 Tromsø, Norway
- Division of Laboratory Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Johan Svartberg
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, 9038 Tromsø, Norway
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Hutchinson MS, Joakimsen RM, Njølstad I, Schirmer H, Figenschau Y, Jorde R. Glycated hemoglobin in diagnosis of diabetes mellitus and pre-diabetes; validation by oral glucose tolerance test. The Tromsø OGTT Study. J Endocrinol Invest 2012; 35:835-40. [PMID: 22186659 DOI: 10.3275/8191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Glycated hemoglobin (HbA(1c)) 6.5% has recently been recommended by the World Health Organization (WHO) and the American Diabetes Association (ADA) as an alternative diagnostic criterion for diabetes mellitus (DM). AIM To evaluate HbA(1c) as an alternative to oral glucose tolerance test (OGTT) for diagnosis of DM and pre-diabetes and to find the optimal HbA(1c) cut-off points for DM and pre-diabetes in our population. SUBJECTS AND METHODS The subjects were recruited from the Tromsø Study, performed for the 6th time in 2007-2008 with 12,984 participants. All subjects with HbA(1c) in the range 5.8-6.9% and a random sample of subjects with levels 5.3-5.7% were invited to an OGTT. RESULTS Among 3476 subjects who completed the OGTT, 199 were diagnosed with DM. The best sensitivity (69.8%) and specificity (81.8%) were found at HbA(1c) 6.2%. For HbA(1c) 6.5% we found a sensitivity of 34.7% and specificity 97.1%. The best cut-off points for impaired fasting glucose (no.=314) and impaired glucose tolerance (no.=404) were found at HbA(1c) 5.9% and 6.0%, respectively. Pre-diabetes detected only by OGTT was associated with worse metabolic characteristics than pre-diabetes detected only by HbA(1c). CONCLUSIONS The optimum HbA(1c) cutoff point for DM in our population was lower than that proposed by WHO and ADA. To establish more precisely the HbA(1c) levels predictive of micro- and macro-vascular complications, long-term prospective studies are needed. Population- specific optimum cut-off points may be necessary.
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Affiliation(s)
- M S Hutchinson
- Tromsø Endocrine Research Group, Department of Clinical Medicine, University Hospital of North Norway, Norway.
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Bergman M, Buysschaert M, Schwarz PEH, Albright A, Narayan KMV, Yach D. Diabetes prevention: global health policy and perspectives from the ground. ACTA ACUST UNITED AC 2012; 2:309-321. [DOI: 10.2217/dmt.12.34] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Heianza Y, Hara S, Arase Y, Saito K, Tsuji H, Kodama S, Hsieh SD, Mori Y, Okubo M, Yamada N, Kosaka K, Sone H. Impact of introducing HbA1c into the diagnostic criteria on prevalence and cardiovascular risk profiles of individuals with newly diagnosed diabetes in Japan: the Toranomon Hospital Health Management Center Study 2 (TOPICS 2). Diabetes Res Clin Pract 2012; 95:283-90. [PMID: 22104263 DOI: 10.1016/j.diabres.2011.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 10/07/2011] [Accepted: 10/17/2011] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate the impact of HbA1c for diagnosis of diabetes and investigate whether cardiovascular risks profiles differ among individuals with diabetes diagnosed by HbA1c or fasting plasma glucose (FPG). METHODS This cross-sectional study involved 26,884 participants (30.6% women; aged 20-91 years) without known diabetes. Subjects were categorized into 4 groups according to the presence or absence of FPG ≥7.0 mmol/L and/or HbA1c ≥6.5%, which were American Diabetes Association criteria. Oral glucose tolerance test data were not available. RESULTS Prevalence of undiagnosed diabetes was 3.6%. Of those individuals, 47.5% fulfilled both two criteria and 26.0% fulfilled only HbA1c criterion. Individuals with diabetes according to FPG ≥7.0 mmol/L alone were characterized as having poorly controlled hypertension while those with HbA1c ≥6.5% alone were characterized as older, female, and having lower blood pressure and γ-glutamyltransferase values. Persons with newly diagnosed diabetes by HbA1c had low HDL cholesterol and high LDL or non-HDL cholesterol levels. CONCLUSIONS Introducing HbA1c into the diagnosis allowed detection of many previously undiagnosed cases of diabetes in Japanese individuals. Those diagnosed by FPG were characterized by hypertension and those diagnosed by HbA1c had unfavorable lipid profiles, reflecting an atherosclerotic trait.
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Affiliation(s)
- Yoriko Heianza
- Department of Endocrinology and Metabolism, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan
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