title: Impact of introducing HbA1c into the diagnostic criteria on prevalence and cardiovascular risk profiles of individuals with newly diagnosed diabetes in Japan: the Toranomon Hospital Health Management Center Study 2 (TOPICS 2).
abstract: OBJECTIVE
  To evaluate the impact of HbA1c for diagnosis of diabetes and investigate whether cardiovascular risks profiles differ among individuals with diabetes diagnosed by HbA1c or fasting plasma glucose (FPG).
  
  
  METHODS
  This cross-sectional study involved 26,884 participants (30.6% women; aged 20-91 years) without known diabetes. Subjects were categorized into 4 groups according to the presence or absence of FPG ≥7.0 mmol/L and/or HbA1c ≥6.5%, which were American Diabetes Association criteria. Oral glucose tolerance test data were not available.
  
  
  RESULTS
  Prevalence of undiagnosed diabetes was 3.6%. Of those individuals, 47.5% fulfilled both two criteria and 26.0% fulfilled only HbA1c criterion. Individuals with diabetes according to FPG ≥7.0 mmol/L alone were characterized as having poorly controlled hypertension while those with HbA1c ≥6.5% alone were characterized as older, female, and having lower blood pressure and γ-glutamyltransferase values. Persons with newly diagnosed diabetes by HbA1c had low HDL cholesterol and high LDL or non-HDL cholesterol levels.
  
  
  CONCLUSIONS
  Introducing HbA1c into the diagnosis allowed detection of many previously undiagnosed cases of diabetes in Japanese individuals. Those diagnosed by FPG were characterized by hypertension and those diagnosed by HbA1c had unfavorable lipid profiles, reflecting an atherosclerotic trait.
authors: Department of Endocrinology and Metabolism, University of Tsukuba Institute of Clinical Medicine, Ibaraki, Japan.
authors: Yoriko
authors: Y
authors: Heianza
authors: Shigeko
authors: S
authors: Hara
authors: Yasuji
authors: Y
authors: Arase
authors: Kazumi
authors: K
authors: Saito
authors: Hiroshi
authors: H
authors: Tsuji
authors: Satoru
authors: S
authors: Kodama
authors: Shiun Dong
authors: SD
authors: Hsieh
authors: Yasumichi
authors: Y
authors: Mori
authors: Minoru
authors: M
authors: Okubo
authors: Nobuhiro
authors: N
authors: Yamada
authors: Kinori
authors: K
authors: Kosaka
authors: Hirohito
authors: H
authors: Sone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin