Fogarty International Centre & Centre of Excellence-Centre for cArdiometabolic Risk Reduction in South Asia, Public Health Foundation of India, New Delhi 122002, India.
Prim Care Diabetes. 2011 Jul;5(2):95-102. doi: 10.1016/j.pcd.2011.02.002. Epub 2011 Apr 6.
To determine the glycosylated haemoglobin (HbA(1c)) cut-points for diabetes and impaired fasting glucose (IFG) among Asian Indians.
Participants (n=525) were a random sample selected from the India Health Study. Based on history and fasting plasma glucose (FPG), participants were classified into known diabetes, newly diagnosed diabetes (NDD), impaired fasting glucose (IFG) [ADA and WHO criteria] or normal fasting glucose (NFG). Receiver Operating Characteristic curves were used to identify the optimum sensitivity and specificity for defining HbA(1c) cut-points for NDD and IFG against the FPG criteria.
There were 64 participants with a known history of diabetes. Of the remaining 461, IFG was present in 44.7% (ADA) and 18.2% (WHO), and 10.4% were NDD. Mean HbA(1c) were 5.4 (±0.04)% for NFG; 5.7 (±0.06)% among IFG-ADA, 5.8 (±0.09)% among IFG-WHO; 7.5 (±0.33)% for NDD and 8.4 (±0.32)% for known diabetes. Optimal HbA(1c) cut-point for NDD was 5.8% (sensitivity=75%, specificity=75.5%, AUC=0.819). Cut-point for IFG (ADA) was 5.5% (sensitivity=59.7%, specificity=59.9%, AUC=0.628) and for IFG (WHO) was 5.6% (sensitivity=60.7%, specificity=65.1%, AUC=0.671).
In this study population from north and south regions of India, the HbA(1c) cut-point that defines NDD (≥5.8%) was much lower than that proposed by an international expert committee and the American Diabetes Association (≥6.5%). A cut-point of ≥5.5% or ≥5.6% defined IFG, and was slightly lower than the ≥5.7% for high risk proposed, but accuracy was less than 70%.
确定亚洲印第安人糖化血红蛋白（HbA1c）的糖尿病和空腹血糖受损（IFG）切点。
参与者（n=525）是从印度健康研究中随机选择的样本。根据病史和空腹血糖（FPG），参与者分为已知糖尿病、新诊断糖尿病（NDD）、空腹血糖受损（IFG）[ADA 和 WHO 标准]或正常空腹血糖（NFG）。使用受试者工作特征曲线确定定义 NDD 和 IFG 的 HbA1c 切点的最佳灵敏度和特异性，以符合 FPG 标准。
有 64 名参与者有已知的糖尿病病史。在其余的 461 名参与者中，IFG 分别占 ADA 的 44.7%和 WHO 的 18.2%，NDD 占 10.4%。NFG 的平均 HbA1c 为 5.4（±0.04）%；IFG-ADA 为 5.7（±0.06）%，IFG-WHO 为 5.8（±0.09）%；NDD 为 7.5（±0.33）%，已知糖尿病为 8.4（±0.32）%。NDD 的最佳 HbA1c 切点为 5.8%（灵敏度=75%，特异性=75.5%，AUC=0.819）。IFG（ADA）的切点为 5.5%（灵敏度=59.7%，特异性=59.9%，AUC=0.628），IFG（WHO）的切点为 5.6%（灵敏度=60.7%，特异性=65.1%，AUC=0.671）。
在来自印度北部和南部地区的研究人群中，定义 NDD（≥5.8%）的 HbA1c 切点远低于国际专家委员会和美国糖尿病协会（≥6.5%）提出的切点。≥5.5%或≥5.6%的切点定义 IFG，略低于高风险的≥5.7%，但准确性低于 70%。
