The Association of Retinopathy and Plasma Glucose and HbA1c: A Validation of Diabetes Diagnostic Criteria in a Chinese Population.
Aims. This study aimed to evaluate the associations of diabetic retinopathy (DR) with fasting plasma glucose (FPG), 2-hour postload plasma glucose (2hPG), and glycated hemoglobin A1c (HbA1c) in a Chinese population.Materials and Methods. A total of 3124 participants, identified from a population-based survey in Pinggu district, were examined by retinal photography (45°). DR was classified according to the Early Treatment Diabetic Retinopathy Study scale. FPG, 2hPG, and HbA1c were tested and categorized by deciles, with the prevalence of DR calculated in each decile.Results. The prevalence of DR increased sharply in the 10th deciles, when FPG exceeded 7.03 mmol/L and HbA1c exceeded 6.4%. Analysis of the receiver operating characteristic curves showed that the optimal cutoffs for detecting DR were 6.52 mmol/L and 5.9% for FPG and HbA1c, respectively. The World Health Organization (WHO) criteria for diagnosing diabetes showed high specificity (90.5-99.5%) and low sensitivity (35.3-65.0%). Further, 6 individuals with retinopathy had normal plasma glucose; however, their characteristics did not differ from those without retinopathy.Conclusions. Thresholds of FPG and HbA1c for detecting DR were observed, and the WHO criteria of diagnosing diabetes were shown to have high specificity and low sensitivity in this population.
Peking University People's Hospital, Beijing, China.
Rui
0000-0001-6005-8245
R
Zhang
Beijing Pinggu Hospital, Beijing, China.
Yufeng
Y
Li
Peking University People's Hospital, Beijing, China.
Simin
S
Zhang
Peking University People's Hospital, Beijing, China.
Xiaoling
0000-0002-7881-0543
X
Cai
Peking University People's Hospital, Beijing, China.
Xianghai
0000-0003-2340-6727
X
Zhou
Peking University People's Hospital, Beijing, China.
Linong
0000-0003-1305-1598
L
Ji
D000328:Adult; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D002681:China; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000378:metabolism*; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human