title: Role of HbA1c in the Screening of Diabetes Mellitus in a Korean Rural Community.
abstract: BACKGROUND
  Recently, the measurement of glycated hemoglobin (HbA1c) was recommended as an alternative to fasting plasma glucose or oral glucose tolerance tests for diagnosing diabetes mellitus (DM). In this study, we analyzed HbA1c levels for diabetes mellitus screening in a Korean rural population.
  
  
  METHODS
  We analyzed data from 10,111 subjects from a Korean Rural Genomic Cohort study and generated a receiver operating characteristic curve to determine an appropriate HbA1c cutoff value for diabetes.
  
  
  RESULTS
  The mean age of the subjects was 56.3±8.1 years. Fasting plasma glucose and 2-hour plasma glucose after 75 g oral glucose tolerance tests were 97.5±25.6 and 138.3±67.1 mg/dL, respectively. The mean HbA1c level of the subjects was 5.7±0.9%. There were 8,809 non-DM patients (87.1%) and 1,302 DM patients (12.9%). A positive relationship between HbA1c and plasma glucose levels and between HbA1c and 2-hour plasma glucose levels after oral glucose tolerance tests was found in a scatter plot of the data. Using Youden's index, the proper cutoff level of HbA1c for diabetes mellitus screening was 5.95% (sensitivity, 77%; specificity, 89.4%).
  
  
  CONCLUSIONS
  Our results suggest that the optimal HbA1c level for DM screening is 5.95%.
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Gun Woo
authors.initials: GW
authors.lastname: Kim
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Lee
authors.forename: Jang Yel
authors.initials: JY
authors.lastname: Shin
authors.forename: Young Goo
authors.initials: YG
authors.lastname: Shin
authors.forename: Sang Baek
authors.initials: SB
authors.lastname: Koh
authors.forename: Choon Hee
authors.initials: CH
authors.lastname: Chung