Annani-Akollor Max Efui, Laing Edwin Ferguson, Addai-Mensah Otchere, Fondjo Linda Ahenkorah, Adu Evans Asamoah, Owiredu Eddie-Williams
Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Medical Diagnostics, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Heliyon. 2020 Aug 1;6(8):e04583. doi: 10.1016/j.heliyon.2020.e04583. eCollection 2020 Aug.
Metabolic syndrome (MetS) is a multifactorial disorder and a predisposing factor for diabetes, heart diseases, and stroke. Glycated haemoglobin (HbA1c) has recently received considerable attention as a potential marker to identify subjects at risk of MetS. This study aimed at assessing the performance of fasting plasma glucose (FPG), the American Diabetes Association (ADA) HbA1c cut-off, and a population-derived HbA1c (pHbA1c) cut-off value as the glycaemic criterion for MetS in a non-diabetic population.
In this cross-sectional study, we recruited 728 non-diabetic Ghanaian adults. Venous blood sample was obtained and fasting plasma insulin and glucose, HbA1c, lipid profile, blood pressure and anthropometric measurements were performed for each respondent.
The prevalence of MetS using the FPG, ADA HbA1c and pHbA1c criteria were 35.2%, 38.5% and 41.8%, respectively. The pHbA1c cut-off identified 6.6% and 3.3% more subjects with MetS when compared with FPG and the ADA HbA1c cut-offs, respectively while the ADA HbA1c cut-off identified 3.3% more subjects with MetS compared with the FPG criterion. The ADA HbA1c criterion showed a substantial agreement (ĸ = 0.79) with the FPG criterion while pHbA1c showed an almost perfect concordance (ĸ = 0.82) with the FPG criterion and an excellent sensitivity and specificity for identifying subjects with MetS in the study population.
Screening of MetS by introduction of the ADA HbA1c criterion in addition to the traditional FPG criterion enhances the detection of more people with MetS. However, the use of population-derived HbA1c cut-off value could potentially identify even greater number of high risk subjects in that specific population.
代谢综合征（MetS）是一种多因素疾病，是糖尿病、心脏病和中风的诱发因素。糖化血红蛋白（HbA1c）最近作为一种识别有患MetS风险个体的潜在标志物受到了广泛关注。本研究旨在评估空腹血糖（FPG）、美国糖尿病协会（ADA）HbA1c临界值以及基于人群的HbA1c（pHbA1c）临界值作为非糖尿病人群中MetS血糖标准的性能。
在这项横断面研究中，我们招募了728名非糖尿病加纳成年人。采集静脉血样本，对每位受试者进行空腹血浆胰岛素和葡萄糖、HbA1c、血脂谱、血压和人体测量。
采用FPG、ADA HbA1c和pHbA1c标准时，MetS的患病率分别为35.2%、38.5%和41.8%。与FPG和ADA HbA1c临界值相比，pHbA1c临界值分别多识别出6.6%和3.3%的MetS患者，而ADA HbA1c临界值比FPG标准多识别出3.3%的MetS患者。ADA HbA1c标准与FPG标准显示出高度一致性（ĸ = 0.79），而pHbA1c与FPG标准显示出几乎完美的一致性（ĸ = 0.82），并且在研究人群中对识别MetS患者具有出色的敏感性和特异性。
除了传统的FPG标准外，引入ADA HbA1c标准筛查MetS可提高对更多MetS患者的检测。然而，使用基于人群的HbA1c临界值可能会在该特定人群中识别出更多的高危个体。
