Optimal hemoglobin A1C cutoff value for diabetes mellitus and pre-diabetes in Pudong New Area,Shanghai, China |
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Authors: | Xianfeng Zhou Xiaonan Ruan Lipeng Hao Yi Zhou Jianjun Gu Hua Qiu Kang Wu Siyu Yu Xinyi Rui Xiaonan Wang Xiaolin Liu Juzhong Ke Genming Zhao Qiao Sun |
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Institution: | 1. School of Public Health, Fudan University, No. 130, Dongan Road, Shanghai 200032, China;2. Center for Disease Prevention and Control, Pudong Preventive Medicine Research Institute of Fudan University, Pudong New Area, No. 3039, Zhangyang Road, Shanghai 200136, China;3. Health and Family Planning Commission, Pudong New Area, No. 990, Chengshan Road, 200125 Shanghai, China |
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Abstract: | AimsDue to the diversity of the Chinese population, it requires considerable research to evaluate HbA1c diagnostic threshold for diagnosis of hyperglycemia.MethodsWe included 7909 subjects aged ≥15 without known diabetes from the baseline of Pudong community cohort in 2013. Participants took oral glucose tolerance test (OGTT) and HbA1c assay. Receiver operating characteristic curve determined the HbA1c threshold in the diagnosis of hyperglycemia.ResultsThe optimal HbA1C threshold for diagnosing newly diagnosed diabetes (NDD) and pre-diabetes in this population was 6.0% (AUC = 0.798, 95%CI: 0.779–0.818) and 5.6% (AUC = 0.655, 95%CI: 0.638–0.671). When compared with elderly age group (≥70 years), HbA1c for detecting NDD performed better in youth (15–39 years: P = 0.003, 40–49 years: P < 0.001). There were 13.81% and 13.34% of participants would be newly detected as NDD and pre-diabetes via HbA1c criteria; meanwhile 3.20% and 15.52% diagnosed as NDD and pre-diabetes by OGTT criteria would be missed diagnosis.ConclusionsThe optimal HbA1c thresholds for NDD and pre-diabetes were lower than ADA criteria. It is necessary to carefully consider whether choose HbA1c as a diagnostic criterion or combine two diagnostic standards. Age-specific diagnostic thresholds should be considered when HbA1c was recommended as diagnostic standard. |
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Keywords: | Diabetes mellitus Hemoglobin A1c Pre-diabetes |
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