Abstract
Aim
A glycated hemoglobin (HbA1c) range of 5.7–6.4% has been included as a category of
increased risk for diabetes. We evaluated whether or not it is reasonable to apply
this HbA1c range to Koreans.
Methods
A retrospective analysis was conducted among subjects who participated in comprehensive
health check-ups annually for 5 years. A total of 9723 subjects were classified into
12 categories based on the baseline HbA1c level.
Results
During 4 years, 601 of the 9723 subjects (6.2%) developed diabetes. Based on ROC analysis,
a HbA1c of 5.7% gave an optimal sensitivity of 62% and specificity of 85% to predict
diabetes. The point showing a substantial difference in the Kaplan-Meier curves was
a HbA1c of 5.7%. The incidence of diabetes was 20.8% among subjects with a baseline
HbA1c of 5.7–6.4%. The hazard ratio of developing diabetes was 6.5 (95% CI, 3.7–10.2)
in the subjects with a HbA1c of 5.7% compared with the bottom category of HbA1c (<5.0%).
Conclusions
A HbA1c cut-point of 5.7% is a suitable value for predicting future diabetes. It is
reasonable to consider a HbA1c range of 5.7–6.4% as a category of increased risk for
diabetes in Korean, similar to an IFG or IGT.
Keywords
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References
- Impaired fasting glucose and impaired glucose tolerance: implications for care.Diabetes Care. 2007; 30: 753-759
- Impaired glucose tolerance and impaired fasting glycaemia: the current status on definition and intervention.Diabet Med. 2002; 19: 708-723
- Cardiometabolic risk in impaired fasting glucose and impaired glucose tolerance: the Atherosclerosis Risk in Communities Study.Diabetes Care. 2007; 30: 325-331
- Diabetes Care. 2010; 33: S11-S61
- Use of HbA1c in predicting progression to diabetes in French men and women: data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR).Diabetes Care. 2006; 29: 1619-1625
- The combination of fasting plasma glucose and glycosylated hemoglobin as a predictor for type 2 diabetes in Korean adults.Korean Diab J. 2009; 33: 306-314
- Combined use of fasting plasma glucose and HbA1c predicts the progression to diabetes in Chinese subjects.Diabetes Care. 2000; 23: 1770-1773
- Regret graphs, diagnostic uncertainty and Youden's Index.Stat Med. 1996; 15: 969-986
- Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.Diabetologia. 1985; 28: 412-419
- Correlation of same-visit HbA1c test with laboratory-based measurements: a MetroNet study.BMC Fam Pract. 2005; 6: 28
- Diabetes Care. 2010; 33: S62-S69
- Predictors of progression from impaired glucose tolerance to NIDDM: an analysis of six prospective studies.Diabetes. 1997; 46: 701-710
- Progression fromnewly acquired impaired fasting glucose to type 2 diabetes.Diabetes Care. 2007; 30: 228-233
- Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: The Hoorn Study.JAMA. 2001; 285: 2109-2113
- Normal fasting plasma glucose levels and type 2 diabetes in young men.N Engl J Med. 2005; 353: 1454-1462
- Normal fasting plasma glucose and risk of type 2 diabetes diagnosis.Am J Med. 2008; 121: 519-524
Article info
Publication history
Published online: June 15, 2011
Accepted:
May 19,
2011
Received:
March 4,
2011
Footnotes
☆This work was partially supported by the Samsung Biomedical Research Institute Grant (SBRI C-A8-223-2). Parts of this study were presented in abstract form at the 8th International Diabetes Federation-Western Pacific Region Congress, Busan, Korea, 17–20 October 2010.
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
