Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction: a 6-year community-based prospective study.
Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction: a 6-year community-based prospective study.
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DOI：
10.2337/dc10-0644
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发表时间：
2011-04
期刊：
影响因子：
16.2
通讯作者：
Cho NH
中科院分区：
文献类型：
--
作者：
Choi SH;Kim TH;Lim S;Park KS;Jang HC;Cho NH
不同的血红蛋白A1 c（A1 C）的截止水平已被建议用于筛查糖尿病，尽管需要更多关于最佳水平的共识，特别是对于不同的种族。我们在一项前瞻性、基于人群的队列研究中评估了A1 C水平在筛查未诊断糖尿病时以及作为6年糖尿病发病预测因素的有用性。共有10，038名参与者从Ansung-Ansan队列研究中招募。所有受试者在基线和每两年一次的随访时接受75 g口服葡萄糖耐量试验。排除既往有糖尿病史的受试者（n = 572），使用受试者工作特征曲线评价A1 C临界值的诊断准确性。采用考克斯比例风险模型预测6年时的糖尿病。在基线时，635名参与者（6.8%）先前未诊断出糖尿病。A1 C临界值为5.9%时，敏感性（68%）和特异性（91%）之和最高。6年时，895例（10.2%）受试者发生了偶发糖尿病。A1 C临界值为5.6%时，识别随后6年糖尿病事件的敏感性（59%）和特异性（77%）之和最高。多变量校正后，基线A1 C ≥5.6%的男性新发糖尿病风险增加2.4倍，女性新发糖尿病风险增加3.1倍。糖化血红蛋白是一种有效、简便的糖尿病筛查方法。A1 C临界值为5.9%可以识别患有未诊断糖尿病的受试者。A1 C ≥5.6%的个体未来患糖尿病的风险增加。
Various cutoff levels of hemoglobin A1c (A1C) have been suggested to screen for diabetes, although more consensus about the best level, especially for different ethnicities, is required. We evaluated the usefulness of A1C levels when screening for undiagnosed diabetes and as a predictor of 6-year incident diabetes in a prospective, population-based cohort study. A total 10,038 participants were recruited from the Ansung-Ansan cohort study. All subjects underwent a 75-g oral glucose tolerance test at baseline and at each biennial follow-up. Excluding subjects with a previous history of diabetes (n = 572), the receiver operating characteristic curve was used to evaluate the diagnostic accuracy of the A1C cutoff. The Cox proportional hazards model was used to predict diabetes at 6 years. At baseline, 635 participants (6.8%) had previously undiagnosed diabetes. An A1C cutoff of 5.9% produced the highest sum of sensitivity (68%) and specificity (91%). At 6 years, 895 (10.2%) subjects had developed incident diabetes. An A1C cutoff of 5.6% had the highest sum of sensitivity (59%) and specificity (77%) for the identification of subsequent 6-year incident diabetes. After multivariate adjustment, men with baseline A1C ≥5.6% had a 2.4-fold increased risk and women had a 3.1-fold increased risk of new-onset diabetes. A1C is an effective and convenient method for diabetes screening. An A1C cutoff of 5.9% may identify subjects with undiagnosed diabetes. Individuals with A1C ≥5.6% have an increased risk for future diabetes.
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影响因子：
8.2
作者：
Sabanayagam, C.;Liew, G.;Wong, T. Y.
通讯作者：
Wong, T. Y.
影响因子：
168.9
作者：
Wong, Tien Y.;Liew, Gerald;Shaw, Jonathan
通讯作者：
Shaw, Jonathan
影响因子：
5.1
作者：
Nakagami, Tomoko;Tominaga, Makoto;Tajima, Naoko
通讯作者：
Tajima, Naoko
糖尿病的医疗标准 - 2009年。
影响因子：
16.2
作者：
American Diabetes Association
通讯作者：
American Diabetes Association
影响因子：
16.2
作者：
Cowie CC;Rust KF;Ford ES;Eberhardt MS;Byrd-Holt DD;Li C;Williams DE;Gregg EW;Bainbridge KE;Saydah SH;Geiss LS
通讯作者：
Geiss LS