title: Glycated hemoglobin and incident type 2 diabetes in singaporean chinese adults: the Singapore Chinese health study.
abstract: BACKGROUND
  The American Diabetes Association recently included glycated hemoglobin in the diagnostic criteria for diabetes, but research on the utility of this biomarker in Southeast Asians is scant. The aim of this study was to evaluate the association between percent HbA1c and incident diabetes in an Asian population of adult men and women without reported diabetes.
  
  
  METHODS
  Data analysis of 5,770 men and women enrolled in the Singapore Chinese Health Study who provided a blood sample at the follow-up I visit (1999-2004) and had no cancer and no reported history of diabetes or cardiovascular disease events. Diabetes was defined as self-report of physician diagnosis, identified at the follow-up II visit (2006-2010).
  
  
  RESULTS
  Hazard ratios (and 95% confidence intervals) for incident diabetes by 5 categories of HbA1c were estimated with Cox regression models and continuous HbA1c with cubic spline analysis. Compared to individuals with an HbA1c ≤ 5.7% (≤39 mmol/mol), individuals with HbA1c 5.8-5.9% (40-41 mmol/mol), 6.0-6.1% (42-43 mmol/mol), 6.2-6.4% (44-47 mmol/mol), and ≥ 6.5% (≥48 mmol/mol) had significantly increased risk for incident diabetes during follow-up. In cubic spline analysis, levels below 5.7% HbA1c were not significantly associated with incident diabetes.
  
  
  CONCLUSIONS
  Our study found a strong and graded association with HbA1c 5.8% and above with incident diabetes in Chinese men and women.
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bancks
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America.
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Odegaard
authors.affiliation: Duke-NUS Graduate Medical School Singapore, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.affiliation: University of Pittsburgh Cancer Institute, Division of Cancer Control and Population Sciences, Pittsburgh, PA, United States of America; University of Pittsburgh, Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, United States of America.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America.
authors.forename: Myron D
authors.initials: MD
authors.lastname: Gross
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pereira
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012846:Singapore / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin