Performance of HbA(1c) for detecting newly diagnosed diabetes and pre-diabetes in Chinese communities living in Beijing.
OBJECTIVE
To determine the performance of glycated haemoglobin (HbA(1c)) as a screening tool for detecting newly diagnosed diabetes (NDM) and pre-diabetes.


METHODS
A diabetes survey was conducted in Beijing among community dwellers who were willing to participate in the survey. Included in the survey were 903 individuals aged 21-79 years without previously diagnosed diabetes and in whom HbA(1c) and other required covariates had been measured. NDM and pre-diabetes (impaired glucose tolerance + impaired fasting glucose) were defined according to the World Health Organization 1999 criteria based on 75-g oral glucose tolerance test. Receiver operating characteristic curve (ROC) was plotted to determine the performance of HbA(1c).


RESULTS
The prevalence of NDM and pre-diabetes was 11.1% and 22.4%, respectively. At an optimal HbA(1c) cut-off point of > or = 6.0%, the test gave a sensitivity of 80.0% and a specificity of 89.8% for diagnosing NDM; at an optimal cut-off point of > or = 5.7%, the sensitivity was 59.4% and specificity 73.9% for diagnosing pre-diabetes. Individuals with HbA(1c)> or = 6.0% tended to be more obese than those with HbA(1c) < 6.0%, but blood pressure and lipid profiles did not differ between the two groups.


CONCLUSIONS
HbA(1c) as a single screening test is adequate to detect newly diagnosed diabetes but is not able to identify pre-diabetes in this obese Chinese population.
Zhou
X H
XH
Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
Ji
L N
LN
Luo
Y Y
YY
Zhang
X Y
XY
Han
X Y
XY
Qiao
Q
Q
D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005951:Glucose Tolerance Test / Q000379:methods; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D012680:Sensitivity and Specificity
D015415:Biomarkers; D006442:Glycated Hemoglobin