Glycated hemoglobin in diagnosis of diabetes mellitus and pre-diabetes; validation by oral glucose tolerance test. The Tromsø OGTT Study.

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: Italy NLM ID: 7806594 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1720-8386 (Electronic) Linking ISSN: 03914097 NLM ISO Abbreviation: J Endocrinol Invest Subsets: MEDLINE
    • Publication Information:
      Publication: 2014- : Berlin : Springer
      Original Publication: Milano, Published for the Italian Society of Endocrinology by Editrice Kurtis.
    • Subject Terms:
      Biomarkers/*analysis ; Diabetes Mellitus, Type 2/*diagnosis ; Glucose Intolerance/*diagnosis ; Glycated Hemoglobin/*metabolism ; Prediabetic State/*diagnosis; Adult ; Aged ; Aged, 80 and over ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 2/epidemiology ; Fasting ; Female ; Glucose Intolerance/epidemiology ; Glucose Tolerance Test ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Prediabetic State/epidemiology ; Sensitivity and Specificity
    • 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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    • Accession Number:
      0 (Biomarkers)
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
    • Publication Date:
      Date Created: 20111222 Date Completed: 20130425 Latest Revision: 20221207
    • Publication Date:
      20240628
    • Accession Number:
      10.3275/8191
    • Accession Number:
      22186659