Comparing glucose and hemoglobin A1c diagnostic tests among a high metabolic risk Hispanic population.
Comparing glucose and hemoglobin A1c diagnostic tests among a high metabolic risk Hispanic population.
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比较高代谢风险西班牙裔人群的葡萄糖和糖化血红蛋白诊断测试。
DOI：
10.1002/dmrr.2874
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Joshipura,Kaumudi
中科院分区：
文献类型：
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作者：
Vega-Vázquez,MónicaA;Ramírez-Vick,Margarita;Muñoz-Torres,FranciscoJ;González-Rodríguez,LoidaA;Joshipura,Kaumudi
BackgroundComparing糖化血红蛋白（HbA 1c）诊断测试糖尿病前期和糖尿病与血糖标准和比较的人分类HbA 1c与葡萄糖levels.MethodsParticipants的代谢概况被招募的圣胡安超重成人纵向研究。参与者主要是西班牙裔（98%），以前没有诊断出糖尿病，年龄在40至65岁之间。参与者归类为正常血糖，糖尿病前期，或糖尿病的基础上基线HbA 1c和血糖标准进行了比较，相对于基线cardiometabolic factors.ResultsThe 1342参与者的平均年龄为50.5 ± 6.8岁，28%是男性。根据血糖标准诊断为前驱糖尿病的患者占31%，根据HbA 1c诊断为前驱糖尿病的患者占53.4%，根据血糖标准诊断为糖尿病的患者占8.1%，根据HbA 1c诊断为糖尿病的患者占6.3%;总体一致率为55.1%。与血糖标准相比，HbA 1c的受试者工作特征曲线下面积在血糖受损组为0.62，在糖尿病组为0.76。在满足糖尿病或前驱糖尿病HbA 1c和血糖标准的亚组中观察到心脏代谢特征更差。糖尿病前期患者的收缩压和稳态模型评估值均显著高于HbA 1c诊断者;糖尿病前期患者的体重指数、腰围、胰岛素生成指数和倾向指数均较低，但稳态模型评估值较高，结论HbA 1c与血糖检测结果的一致性较低。HbA 1c不是糖尿病前期的良好检测，但在这一高风险主要是女性西班牙裔人群中显示出合理的糖尿病有效性。通过HbA 1c，血糖标准或两者分类的人显示不同的代谢特征;组合测试可能是理想的。
BackgroundCompare glycated hemoglobin (HbA1c) diagnostic tests for prediabetes and diabetes with plasma glucose criteria and compare the metabolic profiles of people classified by HbA1cversus by glucose levels.MethodsParticipants were recruited for the San Juan Overweight Adults Longitudinal Study. The participants were primarily Hispanic (98%), without previously diagnosed diabetes, and aged 40 to 65 years. Participants classified as normal glycemic, prediabetes, or diabetes on the basis of baseline HbA1cand plasma glucose criteria were compared with respect to baseline cardiometabolic factors.ResultsThe 1342 participants had a mean age of 50.5 ± 6.8 years and 28% were men. Thirty‐one percent were diagnosed with prediabetes by plasma glucose criteria and 53.4% by HbA1c, and 8.1% were diagnosed with diabetes by plasma glucose criteria and 6.3% by HbA1c; overall concordance rate was 55.1%. The area under the receiver operating characteristic curve of HbA1ccompared to plasma glucose criteria was 0.62 for impaired glucose and 0.76 for diabetes. A worse cardiometabolic profile was seen within subgroups that met HbA1cand plasma glucose criteria for diabetes or prediabetes. Those diagnosed with prediabetes by plasma glucose criteria had significantly higher systolic blood pressure and higher homeostatic model assessment than those diagnosed using HbA1c.Participants diagnosed with diabetes by plasma glucose criteria had lower body mass index, smaller waist circumference, and lower insulinogenic and disposition indices, but higher homeostatic model assessment of insulin resistance, than those diagnosed by HbA1c.ConclusionsLow concordance was seen between HbA1cand glucose measurements. The HbA1cis not a good test for prediabetes but shows reasonable validity for diabetes in this high‐risk predominantly female Hispanic population. People classified by HbA1c, plasma glucose criteria, or both show different metabolic profiles; a combined test may be ideal.