Document Detail


Sensitivity and specificity of glycated hemoglobin as a diagnostic test for diabetes and prediabetes in Arabs.
MedLine Citation:
PMID:  21849526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Glycated hemoglobin (A1C) has been recommended by the American Diabetes Association for the diagnosis of diabetes and prediabetes. The diagnostic utility of A1C has not been evaluated in Arabs, a population at increased risk for developing diabetes.
OBJECTIVE: Our objective was to examine the sensitivity and specificity of A1C for the diagnosis of diabetes and prediabetes in Arabs.
DESIGN & SETTING: In this cross-sectional study, glucose tolerance was classified by the American Diabetes Association diagnostic criteria specified for A1C, fasting plasma glucose, and 75-g oral glucose tolerance test.
PARTICIPANTS: A population-based representative sample of 482 randomly selected adult Arabs without known diabetes was studied.
MAIN OUTCOME MEASURES: Sensitivity, specificity, and area under the receiver operating characteristic curve of A1C diagnostic cutpoints for diabetes and prediabetes were calculated. κ Coefficients were used to test for agreement between A1C categorization and glucose-based diagnoses.
RESULTS: A1C testing correctly identified 5% of individuals diagnosed with diabetes by oral glucose tolerance test, 13% by fasting plasma glucose, and 41% by both criteria. A1C alone identified 14% of individuals diagnosed with impaired glucose tolerance, 9% with impaired fasting glucose, and 33% with both abnormalities. Sensitivity, specificity, and area under the receiver operating characteristic curve were 19% (16-23%), 100% (99-100%), and 77% (69-85%) for diabetes A1C cutpoint and 14% (11-17%), 91% (89-94%), and 57% (52-62%) for prediabetes A1C range. A1C cutpoint of 6.2% for diabetes and 5.1% for prediabetes yielded the highest accuracy but still missed 73% of those with diabetes and 31% with prediabetes. Agreement between A1C and diabetes (κ = 0.2835) or prediabetes (κ = 0.0530) was low.
CONCLUSIONS: A1C-based criteria yield a high proportion of false-negative tests for diabetes and prediabetes in Arabs. Summary: Racial/ethnic differences in A1C performance for diagnosis and prediction of diabetes exist. This paper examines its utility against glucose measurements in an at-risk Arab population.
Authors:
Nicole R Pinelli; Arin S Jantz; Emily T Martin; Linda A Jaber
Related Documents :
8820406 - Genetic predisposition and environmental factors leading to the development of insulin-...
4053146 - Adverse effects of iron supplementation: a comparative trial of a wax-matrix iron prepa...
20113186 - Relationship between serum ferritin and inflammatory biomarkers with insulin resistance...
690886 - The role of the autonomic nervous system in the control of pancreatic endocrine respons...
17957036 - Does impaired mitochondrial function affect insulin signaling and action in cultured hu...
3513606 - Secretin and its c-terminal hexapeptide potentiates insulin release in mouse islets.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-08-17
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  96     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-06     Completed Date:  2011-11-18     Revised Date:  2012-01-24    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E1680-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan 48201-2417, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arabs*
Biological Markers
Blood Glucose / metabolism
Diabetes Mellitus / diagnosis*,  ethnology*
False Negative Reactions
Female
Glucose Tolerance Test
Hemoglobin A, Glycosylated / analysis*
Humans
Male
Middle Aged
Prediabetic State / diagnosis*,  ethnology*
Predictive Value of Tests
ROC Curve
Reproducibility of Results
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Blood Glucose; 0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Tumor Expression of Human Growth Hormone and Human Prolactin Predict a Worse Survival Outcome in Pat...
Next Document:  Wnt/{beta}-Catenin Pathway Deregulation in Childhood Adrenocortical Tumors.