Department of Diabetes, Karamay People's Hospital, Karamay, Xinjiang Uygur Autonomous Region, China.
J Diabetes. 2013 Sep;5(3):282-90. doi: 10.1111/1753-0407.12035. Epub 2013 May 28.
To identify the optimal threshold of HbA1c and to evaluate the predictive performance of HbA1c levels in diagnosing diabetes and prediabetes in a middle-aged and elderly Han Chinese population from northwest China.
In all, 3354 participants aged ≥ 40 years with no history of diabetes from northwest China were enrolled in the present cross-sectional study. All subjects underwent a 75-g oral glucose tolerance test (OGTT), as well as HbA1c testing. HbA1c thresholds for diagnosing diabetes and prediabetes were identified by the highest sum of sensitivity and specificity of each cut-off point, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of the HbA1c threshold.
The mean (± SD) age of the participants was 57 ± 8 years, and 70.75% were women. Based on results of the OGTT, 1347 (40.16%) subjects had impaired fasting glucose and/or impaired glucose tolerance, and 725 (21.62%) had diabetes. The area under the ROC curve for detecting undiagnosed diabetes and prediabetes by HbA1c levels was 0.810 (95% confidence interval [CI] 0.796-0.823) and 0.732 (95% CI 0.717-0.747), respectively. HbA1c threshold of 6.4% and 6.1% produced the highest sum of sensitivity (60.00% and 61.49%) and specificity (87.33% and 73.24%) for diagnosing diabetes and prediabetes, respectively.
HbA1c is an effective and convenient method for diagnosing diabetes and prediabetes. HbA1c thresholds of 6.4% and 6.1% may be used as diagnostic criteria for diabetes and prediabetes, respectively, in the Han Chinese population living in northwest China.
确定 HbA1c 的最佳阈值，并评估 HbA1c 水平在诊断中国西北地区中老年汉族人群糖尿病和糖尿病前期中的预测性能。
本横断面研究共纳入 3354 名年龄≥40 岁、无糖尿病史的中国西北地区居民。所有受试者均接受 75g 口服葡萄糖耐量试验（OGTT）和 HbA1c 检测。通过每个切点的敏感性和特异性之和最高来确定诊断糖尿病和糖尿病前期的 HbA1c 阈值，并使用受试者工作特征（ROC）曲线评估 HbA1c 阈值的诊断准确性。
参与者的平均（±标准差）年龄为 57±8 岁，70.75%为女性。根据 OGTT 结果，1347 名（40.16%）受试者空腹血糖受损和/或糖耐量受损，725 名（21.62%）患有糖尿病。HbA1c 水平检测未诊断糖尿病和糖尿病前期的 ROC 曲线下面积分别为 0.810（95%置信区间 [CI] 0.796-0.823）和 0.732（95% CI 0.717-0.747）。HbA1c 阈值为 6.4%和 6.1%时，诊断糖尿病和糖尿病前期的敏感性（60.00%和 61.49%）和特异性（87.33%和 73.24%）之和最高。
HbA1c 是诊断糖尿病和糖尿病前期的有效且便捷的方法。HbA1c 阈值为 6.4%和 6.1%时，可分别作为中国西北地区汉族人群诊断糖尿病和糖尿病前期的标准。
