Diabetes Metab J.  2014 Dec;38(6):480-483. 10.4093/dmj.2014.38.6.480.

Glycated Hemoglobin Value for Fasting Plasma Glucose of 126 mg/dL in Korean: The 2011 Korea National Health and Nutrition Examination Survey

• Kim JM
• Hong JW
• Won JC
• Noh JH
• Ko KS
• Rhee BD
• Kim DJ

• KMID: 2174086
• DOI: http://doi.org/10.4093/dmj.2014.38.6.480

Abstract

We aimed to estimate the cutoff value of glycated hemoglobin (HbA1c, A1c) for fasting plasma glucose (FPG) of 126 mg/dL in the Korean adult population, using the 2011 Korea National Health and Nutrition Examination Survey. A total of 5,421 participants without a history of diabetes and over 19 years of age were included in the analysis. A point-wise area under the receiver operating characteristic curve was used to estimate the optimal A1c cutoff value. A1c threshold of 6.1% produced the highest sum of sensitivity (85.2%) and specificity (90.5%) for FPG of 126 mg/dL (area under the curve, 0.941, P<0.001). A1c of 6.5% produced a sensitivity of 67.7% and specificity of 98.0% for FPG of 126 mg/dL. Considering A1c as one of three criteria for the diagnosis of diabetes and the specificity of an A1c cutoff of 6.5%, the current diagnostic criteria of A1c> or =6.5% might be acceptable in the Korean adult population.

Keyword

Diabetes mellitus; Diagnosis; Hemoglobin A, glycated

MeSH Terms

Adult
Blood Glucose*
Diabetes Mellitus
Diagnosis
Fasting*
Hemoglobin A, Glycosylated*
Humans
Korea
Nutrition Surveys*
ROC Curve
Sensitivity and Specificity

Reference

1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010; 33:Suppl 1. S62–S69.

2. Korea Centers for Disease Control and Prevention (KCDC). Korea National Health and Nutrition Examination Survey. updated 2013 Jun 27. Available from: http://knhanes.cdc.go.kr.

3. Lee H, Oh JY, Sung YA, Kim DJ, Kim SH, Kim SG, Moon S, Park Ie B, Rhee EJ, Chung CH, Kim BJ, Ku BJ. Optimal hemoglobin A1C cutoff value for diagnosing type 2 diabetes mellitus in Korean adults. Diabetes Res Clin Pract. 2013; 99:231–236.

4. Choi SH, Kim TH, Lim S, Park KS, Jang HC, Cho NH. Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction: a 6-year community-based prospective study. Diabetes Care. 2011; 34:944–949.

5. Bennett CM, Guo M, Dharmage SC. HbA(1c) as a screening tool for detection of type 2 diabetes: a systematic review. Diabet Med. 2007; 24:333–343.

6. Kramer CK, Araneta MR, Barrett-Connor E. A1C and diabetes diagnosis: the Rancho Bernardo Study. Diabetes Care. 2010; 33:101–103.

7. Lu ZX, Walker KZ, O'Dea K, Sikaris KA, Shaw JE. A1C for screening and diagnosis of type 2 diabetes in routine clinical practice. Diabetes Care. 2010; 33:817–819.

8. Hu Y, Liu W, Chen Y, Zhang M, Wang L, Zhou H, Wu P, Teng X, Dong Y, Zhou J, Xu H, Zheng J, Li S, Tao T, Hu Y, Jia Y. Combined use of fasting plasma glucose and glycated hemoglobin A1c in the screening of diabetes and impaired glucose tolerance. Acta Diabetol. 2010; 47:231–236.

9. Kumar PR, Bhansali A, Ravikiran M, Bhansali S, Dutta P, Thakur JS, Sachdeva N, Bhadada SK, Walia R. Utility of glycated hemoglobin in diagnosing type 2 diabetes mellitus: a community-based study. J Clin Endocrinol Metab. 2010; 95:2832–2835.

10. Pani LN, Korenda L, Meigs JB, Driver C, Chamany S, Fox CS, Sullivan L, D'Agostino RB, Nathan DM. Effect of aging on A1C levels in individuals without diabetes: evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001-2004. Diabetes Care. 2008; 31:1991–1996.

11. Kilpatrick ES, Dominiczak MH, Small M. The effects of ageing on glycation and the interpretation of glycaemic control in type 2 diabetes. QJM. 1996; 89:307–312.