| Applicability of a Combination of Hemoglobin A1c and Fasting Plasma Glucose in Population-based Prediabetes Screening. | |
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MedLine Citation:
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PMID: 22268513 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Purpose: The purpose of this study is to determine (a) concordance between a combination of HbA1c and FPG (HbA1c+FPG) and a combination of FPG and 2hPG (FPG+2hPG), and (b) whether substituting FPG+2hPG with HbA1c+FPG can enhance the detection of prediabetes in diabetes free non-Hispanic Whites, non-Hispanic Blacks and Mexican-Americans adults. Methods: Data (n=1376) from the 2007-2008 U.S. National Health and Nutrition Examination Surveys were used for this investigation. Prediabetes cut points were determined using 5.7-6.4%, 100-125 mg/dl, and 140-199 mg/dl of HbA1c, FPG and 2hPG, respectively. Concordances between HbA1c and FPG, HbA1c and 2hPG, HbA1c+FPG and FPG+2hPG in screening for undiagnosed prediabetes were determined using sensitivity, specificity, and positive and negative likelihood ratios. Results: The overall concordance between HbA1c+FPG and FPG+2hPG in screening for prediabetes was high as indicated by sensitivity of 92.4% [95% CI=90.5-94.5]) and specificity of 84.1% [95% CI=81.2-87.0]. The application of HbA1c+FPG was associated with higher prevalence of prediabetes compared to FPG+2hPG. Compared with FPG+2hPG, screening with HbA1c+FPG was associated with 3.2%, 24.3% and 4.2%relative increased in identification of prediabetes in nondiabetic non-Hispanic Whites, non-Hispanic Blacks and Mexican-Americans, respectively. Conclusions: The enhanced prevalence of prediabetes using HbA1c+FPG compared with FPG+2hPG calls for the need to redefine at a more basic and a more practical level how to apply HbA1c in screening for prediabetes. A redefined HbA1c that incorporates FPG, age, race/ethnicity and BMI may put forward a better way to use HbA1c in population-based and clinical settings. |
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Authors:
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Ike S Okosun; Monique Davis-Smith; J Paul Seale; John Ngulefac |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-24 |
Journal Detail:
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Title: Journal of diabetes Volume: - ISSN: 1753-0407 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-1-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101504326 Medline TA: J Diabetes Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Ruijin Hospital and Blackwell Publishing Asia Pty Ltd. |
Affiliation:
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Institute of Public Health, Georgia State University, Atlanta, Georgia 30302 Department of Family Medicine, Mercer University School of Medicine, Macon, Georgia, 31210 Scimetrika Company. Atlanta, Georgia 30329. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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