title: Comparing HbA1c, fasting and 2-h plasma glucose for screening for abnormal glucose regulation in patients undergoing coronary angiography.
abstract: BACKGROUND
  We aimed to investigate the prevalence of undiagnosed abnormal glucose regulation (AGR, including diabetes and prediabetes) in patients undergoing coronary angiography (CAG) by using both glycated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) to screen, and to compare the performance of fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), and HbA1c for screening for AGR.
  
  
  METHODS
  Eligible patients were adults without known diabetes who were admitted for CAG. Patients' glucose regulation status was defined by conducting HbA1c and OGTT 2-4 weeks after hospital discharge. The performance of FPG, 2hPG, and HbA1c for detecting AGR was evaluated using receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  A total of 689 subjects were included. According to OGTT, the prevalence rates of diabetes and prediabetes were 19.9% and 41.7%, respectively. The corresponding values were 28.0% and 60.4%, respectively, when HbA1c was adopted as a diagnostic criterion in addition to OGTT. For detecting diabetes, the area under the ROC curve (AUC) was higher for HbA1c than for FPG (0.87 vs. 0.80, p=0.005), but was not significantly different from that for 2hPG (0.87 vs. 0.88, p=0.58). For detecting AGR, the AUC was higher for HbA1c than for either FPG (0.94 vs. 0.74, p<0.001) or 2hPG (0.94 vs. 0.83, p<0.001).
  
  
  CONCLUSIONS
  Using HbA1c and OGTT to screen, we reported an extremely high prevalence of previously undiagnosed AGR (28.0% diabetes and 60.4% prediabetes) in patients admitted for CAG. HbA1c may be adopted as an alternative to OGTT for screening for AGR in patients undergoing CAG.
authors.forename: Jun-Sing
authors.initials: JS
authors.lastname: Wang
authors.forename: I-Te
authors.initials: IT
authors.lastname: Lee
authors.forename: Wen-Jane
authors.initials: WJ
authors.lastname: Lee
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.forename: Chia-Po
authors.initials: CP
authors.lastname: Fu
authors.forename: Wen-Lieng
authors.initials: WL
authors.lastname: Lee
authors.forename: Kae-Woei
authors.initials: KW
authors.lastname: Liang
authors.forename: Wayne Huey-Herng
authors.initials: WH
authors.lastname: Sheu
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D017023:Coronary Angiography; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis*; D005215:Fasting / Q000097:blood*; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis*; D012372:ROC Curve
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin