Document Detail


Usefulness of Hemoglobin A1c as a Criterion to Define the Metabolic Syndrome in a Cohort of Italian Nondiabetic White Subjects.
MedLine Citation:
PMID:  21420057     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We compared the performance of hemoglobin A1c (HbA1c) versus the fasting plasma glucose (FPG) in diagnosing the metabolic syndrome and assessed the diagnostic accuracy of the metabolic syndrome definition using HbA1c in identifying insulin-resistant subjects. The cardiometabolic risk factors, HbA1c, and glucose tolerance were analyzed in 774 nondiabetic white subjects. Insulin sensitivity was estimated with an oral glucose tolerance test-derived insulin sensitivity index. Insulin resistance was defined as the lower quartile of insulin sensitivity index. A 90.9% agreement existed between the use of HbA1c and the FPG for diagnosis of the metabolic syndrome (κ coefficient = 0.813); however, the proportion of subjects who met the metabolic syndrome criteria using the HbA1c was greater (42.1% vs 39.7%). Compared to the subjects who met the metabolic syndrome criteria using the FPG alone, those with the metabolic syndrome using the HbA1c-alone criterion were younger, had greater visceral adiposity, greater levels of inflammatory markers and liver enzymes, and lower blood pressure. In a logistic regression analysis with adjustment for age and gender, the subjects with the metabolic syndrome using the HbA1c criterion only had a 3.6-fold increase risk of having insulin resistance, defined as the lowest quartile of the insulin sensitivity index. A similar risk (3.8-fold) was observed in those who met the metabolic syndrome criteria using FPG alone. Insulin-resistant subjects who did not meet the criteria for the metabolic syndrome using the HbA1c had an unfavorable cardiovascular disease risk profile. In conclusion, although a good agreement existed between the HbA1c and FPG criteria for the diagnosis of the metabolic syndrome, appreciably different groups of subjects were classified using each method.
Authors:
Elena Succurro; Maria Adelaide Marini; Franco Arturi; Alessandro Grembiale; Teresa Vanessa Fiorentino; Francesco Andreozzi; Angela Sciacqua; Renato Lauro; Marta Letizia Hribal; Francesco Perticone; Giorgio Sesti
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-18
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Experimental and Clinical Medicine, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.
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