title: Sensitivity of A1C to diagnose diabetes is decreased in high-risk older Southeast Asians.
abstract: OBJECTIVE
  To determine the effect of ageing on the performance of glycosylated haemoglobin A1C (A1C) for the diagnosis of diabetes mellitus (DM) in Southeast Asians.
  
  
  METHODS
  A1C was measured in 511 subjects (mean age of 52.4 years; range 14-93) undergoing the 75-g oral glucose tolerance test (OGTT). Using receiver operating curve (ROC) analysis, the performance of A1C for the diagnosis of diabetes (using different standard criteria) was compared between 4 groups: <45 (n=156), 45-54 (n=132), 55-64 (n=122), ≥65 years (n=101).
  
  
  RESULTS
  Subjects aged ≥65 years had the highest false-negative rates with fasting plasma glucose (60.8%) and A1C (35.1%), the smallest area under ROC curve (0.723, 95% CI 0.627-0.820), the lowest sensitivity (58.7%, 95% CI 50.4-65.7) and specificity (71.1%, 95% CI 57.3-82.6) of A1C 6.5%, compared to the younger age groups.
  
  
  CONCLUSIONS
  OGTT is preferable for diagnosis of DM in older Southeast Asian adults.
authors.affiliation: Changi General Hospital, Singapore, Singapore. joan_khoo@cgh.com.sg
authors.forename: Joan
authors.initials: J
authors.lastname: Khoo
authors.forename: Tunn-Lin
authors.initials: TL
authors.lastname: Tay
authors.forename: Joo-Pin
authors.initials: JP
authors.lastname: Foo
authors.forename: Eberta
authors.initials: E
authors.lastname: Tan
authors.forename: Shui-Boon
authors.initials: SB
authors.lastname: Soh
authors.forename: Richard
authors.initials: R
authors.lastname: Chen
authors.forename: Vanessa
authors.initials: V
authors.lastname: Au
authors.forename: Ben
authors.initials: B
authors.lastname: Jen-Min Ng
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005188:False Negative Reactions; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012306:Risk; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human