title: Ideal glycated hemoglobin cut-off points for screening diabetes and prediabetes in a Chinese population.
abstract: OBJECTIVE
  The aims of the present study were to evaluate the diagnostic value of fasting plasma glucose, 2-h postload plasma glucose and glycosylated hemoglobin (HbA1c) measurements in the screening of diabetes and prediabetes, and to determine the cut-off point of HbA1c in the diagnosis of diabetes and prediabetes in a Chinese population.
  
  
  METHODS
  A total of 7,611 individuals aged 40 years or older, who did not have a prior history of diabetes, were randomly selected in the Changchun area. For each participant, a questionnaire was completed, and a physical examination and an oral glucose tolerance test were carried out. The values of fasting plasma glucose, 2-h postload plasma glucose and HbA1c were compared by area under the receiver operating characteristic curves. The Youden index was used to identify the optimal cut-off point of HbA1c in the diagnosis of diabetes and prediabetes.
  
  
  RESULTS
  The prevalence of newly diagnosed diabetes and prediabetes was 12.71% and 29.39%, respectively. In participants with newly diagnosed diabetes, the area under the receiver operating characteristic curve was 0.8368 for fasting plasma glucose, 0.9330 for 2-h postload plasma glucose and 0.8064 for HbA1c; whereas for prediabetes, these values were 0.8022, 0.9288 and 0.6895, respectively. In addition, an HbA1c threshold of 6.3% showed the highest Youden index (0.4799) for detecting diabetes; furthermore, an HbA1c threshold of 5.8% showed the highest Youden index (0.2866) for detecting prediabetes.
  
  
  CONCLUSIONS
  HbA1c ≥6.3% (45 mmol/mol) and between 5.8% and 6.2% (40-44 mmol/mol) were the optimal cut-off values for the diagnosis of diabetes and prediabetes, respectively, in a Chinese population.
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Yujia
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Xianchao
authors.initials: X
authors.lastname: Xiao
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Chenglin
authors.initials: C
authors.lastname: Sun
authors.affiliation: Epidemiology, The First Hospital of Jilin University, Changchun, China.
authors.forename: Suyan
authors.initials: S
authors.lastname: Tian
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Yazhen
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: You
authors.initials: Y
authors.lastname: Lv
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Liwen
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.
authors.forename: Guixia
authors.initials: G
authors.lastname: Wang
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002681:China; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood* / Q000175:diagnosis*; D012372:ROC Curve; D012016:Reference Values
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Chinese adults; Receiver operating characteristic curves; Type 2 diabetes mellitus