title: Validity of glycated hemoglobin in screening and diagnosing type 2 diabetes mellitus in Chinese subjects.
abstract: OBJECTIVE
  The application of glycated hemoglobin (HbA(1c)) for the diagnosis of diabetes is currently under extensive discussion. In this study, we explored the validity of using HbA(1c) as a screening and diagnostic test in Chinese subjects recruited in Nanjing, China.
  
  
  METHODS
  In total, 497 subjects (361 men and 136 women) with fasting plasma glucose (PG) ≥ 5.6 mmol/L were recruited to undergo the oral glucose tolerance test (OGTT) and HbA(1c) test. Plasma lipid, uric acid, and blood pressure were also measured.
  
  
  RESULTS
  Using a receiver operating characteristic curve, the optimal cutoff point of HbA(1c) related to diabetes diagnosed by the OGTT was 6.3%, with a sensitivity and specificity of 79.6% and 82.2%, respectively, and the area under the curve was 0.87 (95% confidence interval, 0.83 to 0.92). A HbA(1c) level of 6.5% had a sensitivity and specificity of 62.7% and 93.5%, respectively. When comparing the HbA(1c) ≥ 6.5% or OGTT methods for diagnosing diabetes, the former group had significantly higher HbA(1c) levels and lower levels of fasting and 2-hour PG than the latter group. No significant difference was observed in the other metabolism indexes between the two groups.
  
  
  CONCLUSIONS
  Our results suggest that HbA(1c) ≥ 6.5% has reasonably good specificity for diagnosing diabetes in Chinese subjects, which is in concordance with the American Diabetes Association recommendations.
authors.affiliation: Diabetes Care and Research Center, Jiangsu Province Institute of Geriatrics, Nanjing, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Yu
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Ouyang
authors.forename: Qing-Lin
authors.initials: QL
authors.lastname: Lou
authors.forename: Liu-Bao
authors.initials: LB
authors.lastname: Gu
authors.forename: Yong-Zhen
authors.initials: YZ
authors.lastname: Mo
authors.forename: Gary T
authors.initials: GT
authors.lastname: Ko
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Chow
authors.forename: Wing-Yee
authors.initials: WY
authors.lastname: So
authors.forename: Ronald
authors.initials: R
authors.lastname: Ma
authors.forename: Alice
authors.initials: A
authors.lastname: Kong
authors.forename: Nicola
authors.initials: N
authors.lastname: Brown
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nan
authors.forename: Juliana
authors.initials: J
authors.lastname: Chan
authors.forename: Rong-Wen
authors.initials: RW
authors.lastname: Bian
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002681:China / Q000453:epidemiology; D002851:Chromatography, High Pressure Liquid / Q000592:standards; D002852:Chromatography, Ion Exchange / Q000592:standards; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test / Q000592:standards; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human