| The potential impact and optimal cut-points of using glycated haemoglobin, HbA1c, to detect people with impaired glucose regulation in a UK multi-ethnic cohort. | |
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MedLine Citation:
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PMID: 20633944 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Recommended diagnostic cut-points to detect impaired glucose regulation (IGR, also termed prediabetes: impaired fasting glucose and/or impaired glucose tolerance based on WHO 1999 criteria) are HbA1c 6.0-6.4% and 5.7-6.4% from an International Expert Committee and American Diabetes Association, respectively. We investigated the impact on prevalence/phenotype from using these criteria compared to IGR detected on oral glucose tolerance testing (OGTT) and determined optimal HbA1c cut-points for IGR in a multi-ethnic cohort. METHODS: Analysis of 8696 participants in the LEADER study of primary care individuals aged 40-75 years without diabetes, in Leicestershire (UK) who underwent OGTT and had HbA1c measured. RESULTS: Use of OGTT detected less people with IGR (n=1407, 16.2%) compared to HbA1c 6.0-6.4% (n=1610, 18.5%) and HbA1c 5.7-6.4%(n=3904, 44.9%), a 1.1- and 2.8-fold increase in prevalence, respectively. There were 930 (10.7%) and 534 (6.1%) people with IGR on OGTT not detected using HbA1c 6.0-6.4% and 5.7-6.4%, respectively. From ROC curve analysis, the optimal cut-point for detecting IGR in white Europeans was HbA1c>or=5.8%, sensitivity/specificity 61.5%/67.9%, but in south Asians HbA1c>or=6.0%, sensitivity/specificity 63.8%/69.4%. CONCLUSION: Recommended HbA1c cut-points to detect IGR significantly increase numbers detected, however introduce a change in people identified. Using HbA1c 6.0-6.4% lacks sensitivity in white Europeans, but is a reasonable option in south Asians. |
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Authors:
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Samiul A Mostafa; Kamlesh Khunti; Balasubramanian Thiagarajan Srinivasan; David Webb; Laura J Gray; Melanie J Davies |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-07-14 |
Journal Detail:
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Title: Diabetes research and clinical practice Volume: 90 ISSN: 1872-8227 ISO Abbreviation: Diabetes Res. Clin. Pract. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-06 Completed Date: 2011-01-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8508335 Medline TA: Diabetes Res Clin Pract Country: Ireland |
Other Details:
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Languages: eng Pagination: 100-8 Citation Subset: IM |
Affiliation:
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Division of Diabetes and Endocrinology, Department of Cardiovascular Sciences, Leicester Royal Infirmary, Leicester, UK. samiul.mostafa@uhl-tr.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Asian Continental Ancestry Group Blood Glucose / analysis Cohort Studies European Continental Ancestry Group Female Glucose Intolerance / blood*, diagnosis*, epidemiology, ethnology Glucose Tolerance Test Great Britain / epidemiology Hemoglobin A, Glycosylated / analysis* Humans Male Mass Screening Middle Aged Phenotype Practice Guidelines as Topic Prediabetic State / blood*, diagnosis*, epidemiology, ethnology Sensitivity and Specificity |
| Grant Support | |
ID/Acronym/Agency:
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//Department of Health |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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