Cha Seon-Ah, Chon Suk, Yun Jae-Seung, Rhee Sang Youl, Lim Sun-Young, Yoon Kun-Ho, Ahn Yu-Bae, Ko Seung-Hyun, Woo Jeong-Taek, Lee Jin-Hee
Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine , The Catholic University of Korea, Suwon-si, South Korea.
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
Diabetes Metab Res Rev. 2020 Oct;36(7):e3324. doi: 10.1002/dmrr.3324. Epub 2020 Jul 14.
The primary aim of this study was to assess the utility of fasting plasma glucose (FPG) and HbA1c to identify diabetes by the 2-hour plasma glucose (PG) criterion in the Korean population at high risk for diabetes.
A total of 1646 participants with a body mass index of ≥23 kg/m without having a history of diabetes were recruited in this study. The cut-off values of FPG and HbA1c for detecting diabetes were identified using the Youden index using receiver operating characteristic (ROC) analysis. The gold standard for diabetes prediction was defined by the 2-hour PG level of ≥200 mg/dL.
The participants comprised 54.0% women, and the mean age of all participants was 55.0 ± 8.1 years. At baseline, FPG was 104.1 ± 14.2 mg/dL, the 2-hour PG value was 162.9 ± 55.3 mg/dL, and HbA1c was 5.9% ± 0.5%. Four hundred and forty-six subjects (27.1%) were diagnosed with diabetes and 976 subjects (59.3%) were determined to be at prediabetes. The area under the ROC curve (AUC) of FPG and HbA1c for diabetes were 0.776 and 0.802, while the AUC of FPG and HbA1c for prediabetes were 0.515 and 0.477. The optimal cut-off value for diagnosing diabetes of FPG and HbA1c were 104.5 mg/dL (sensitivity 75.8%, specificity 67.5%) and 5.9% (sensitivity 80.6%, specificity 63.8%), respectively.
FPG of 104.5 mg/dL and HbA1c value of 5.9% (41 mmol/mol) can be used as an optimal screening value for diabetes by 2-hour PG criterion in the Korean population at high risk for diabetes.
本研究的主要目的是评估空腹血糖（FPG）和糖化血红蛋白（HbA1c）在韩国糖尿病高危人群中，依据2小时血糖（PG）标准来识别糖尿病的效用。
本研究共招募了1646名体重指数≥23kg/m²且无糖尿病病史的参与者。使用受试者工作特征（ROC）分析的约登指数确定FPG和HbA1c用于检测糖尿病的临界值。糖尿病预测的金标准由2小时PG水平≥200mg/dL定义。
参与者中女性占54.0%，所有参与者的平均年龄为55.0±8.1岁。基线时，FPG为104.1±14.2mg/dL，2小时PG值为162.9±55.3mg/dL，HbA1c为5.9%±0.5%。446名受试者（27.1%）被诊断为糖尿病，976名受试者（59.3%）被确定为糖尿病前期。FPG和HbA1c用于糖尿病诊断的ROC曲线下面积（AUC）分别为0.776和0.802，而FPG和HbA1c用于糖尿病前期诊断的AUC分别为0.515和0.477。FPG和HbA1c诊断糖尿病的最佳临界值分别为104.5mg/dL（敏感性75.8%，特异性67.5%）和5.9%（敏感性80.6%，特异性63.8%）。
对于韩国糖尿病高危人群，104.5mg/dL的FPG和5.9%（41mmol/mol）的HbA1c值可作为依据2小时PG标准诊断糖尿病的最佳筛查值。
