Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
J Korean Med Sci. 2012 Sep;27(9):1057-61. doi: 10.3346/jkms.2012.27.9.1057. Epub 2012 Aug 22.
The metabolic syndrome (MetS) is the clustering of cardiovascular risk factors and known as a powerful predictor of diabetes and cardiovascular disease. Glycated hemoglobin (HbA1c) is used as one of the diagnostic criteria for diabetes and category of increased risk for diabetes. We examined the usefulness of HbA1c as a diagnostic tool for MetS and to determine the cut-off value of HbA1c as a criterion for MetS, in non-diabetic Korean subjects. We analyzed 7,307 participants (male: 4,181, 57%) in a medical check-up program, and applied the newly recommended guidelines of the International Diabetes Federation for diagnosis of MetS. The mean HbA1c was 5.54% in all subjects and showed no significant difference between genders. Using receiver-operating characteristic curve, HbA1c value corresponding to the fasting plasma glucose value of 100 mg/dL was 5.65% (sensitivity 52.3%, specificity 76.7%). The prevalence of MetS was 8.5% according to the IDF guideline and 10.9% according to HbA1c value of 5.7%, showing 69.5% agreement rate. The detection rate of MetS increased to 25.7% using the HbA1c criterion of 5.7% instead of fasting hyperglycemia. This study suggests that HbA1c might be used as a diagnostic criterion for MetS and the appropriate cut-off value of HbA1c may be 5.65% in this Korean population.
代谢综合征（MetS）是心血管危险因素的聚集，被认为是糖尿病和心血管疾病的强有力预测因子。糖化血红蛋白（HbA1c）被用作糖尿病的诊断标准之一，以及糖尿病风险增加的类别。我们研究了 HbA1c 作为 MetS 诊断工具的有用性，并确定 HbA1c 的切点值作为 MetS 的诊断标准，在非糖尿病的韩国人群中。我们分析了医疗体检计划中的 7307 名参与者（男性：4181，57%），并应用国际糖尿病联合会新推荐的 MetS 诊断指南。所有受试者的平均 HbA1c 为 5.54%，性别之间无显著差异。使用受试者工作特征曲线，与空腹血糖值 100mg/dL 对应的 HbA1c 值为 5.65%（敏感性 52.3%，特异性 76.7%）。根据 IDF 指南，MetS 的患病率为 8.5%，根据 HbA1c 值为 5.7%，患病率为 10.9%，显示 69.5%的一致性。使用 HbA1c 标准 5.7%代替空腹高血糖时，MetS 的检出率增加到 25.7%。本研究表明，HbA1c 可能被用作 MetS 的诊断标准，在该韩国人群中，HbA1c 的适当切点值可能为 5.65%。
