title: Comparing glucose and hemoglobin A1cdiagnostic tests among a high metabolic risk Hispanic population.
abstract: Compare glycated hemoglobin (HbA1c) diagnostic tests for prediabetes and diabetes with plasma glucose criteria and compare the metabolic profiles of people classified by HbA1cversus by glucose levels.
  
  
  
  Participants were recruited for the San Juan Overweight Adults Longitudinal Study. The participants were primarily Hispanic (98%), without previously diagnosed diabetes, and aged 40 to 65 years. Participants classified as normal glycemic, prediabetes, or diabetes on the basis of baseline HbA1cand plasma glucose criteria were compared with respect to baseline cardiometabolic factors.
  
  
  
  The 1342 participants had a mean age of 50.5 ± 6.8 years and 28% were men. Thirty-one percent were diagnosed with prediabetes by plasma glucose criteria and 53.4% by HbA1c, and 8.1% were diagnosed with diabetes by plasma glucose criteria and 6.3% by HbA1c; overall concordance rate was 55.1%. The area under the receiver operating characteristic curve of HbA1ccompared to plasma glucose criteria was 0.62 for impaired glucose and 0.76 for diabetes. A worse cardiometabolic profile was seen within subgroups that met HbA1cand plasma glucose criteria for diabetes or prediabetes. Those diagnosed with prediabetes by plasma glucose criteria had significantly higher systolic blood pressure and higher homeostatic model assessment than those diagnosed using HbA1c. Participants diagnosed with diabetes by plasma glucose criteria had lower body mass index, smaller waist circumference, and lower insulinogenic and disposition indices, but higher homeostatic model assessment of insulin resistance, than those diagnosed by HbA1c.
  
  
  
  Low concordance was seen between HbA1cand glucose measurements. The HbA1cis not a good test for prediabetes but shows reasonable validity for diabetes in this high-risk predominantly female Hispanic population. People classified by HbA1c, plasma glucose criteria, or both show different metabolic profiles; a combined test may be ideal.
authors.affiliation: Department of Medicine, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Mónica A
authors.initials: MA
authors.lastname: Vega-Vázquez
authors.affiliation: Department of Medicine, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Margarita
authors.initials: M
authors.lastname: Ramírez-Vick
authors.affiliation: School of Dental Medicine, Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Muñoz-Torres
authors.affiliation: Department of Medicine, Endocrinology, Diabetes and Metabolism Section, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Loida A
authors.initials: LA
authors.lastname: González-Rodríguez
authors.affiliation: School of Dental Medicine, Center for Clinical Research and Health Promotion, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Kaumudi
authors.initials: K
authors.lastname: Joshipura
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000097:blood*; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: HbA1c; IGT; diabetes; diagnosis; ethnicity