Ji Cheol Bae1, Eun Jung Rhee2, Won Young Lee3, Se Eun Park2, Cheol Young Park2, Ki Won Oh2, Sung Woo Park2, Sun Woo Kim2. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: drlwy@hanmail.net.
Abstract
AIM: A glycated hemoglobin (HbA1c) range of 5.7-6.4% has been included as a category of increased risk for diabetes. We evaluated whether or not it is reasonable to apply this HbA1c range to Koreans. METHODS: A retrospective analysis was conducted among subjects who participated in comprehensive health check-ups annually for 5 years. A total of 9723 subjects were classified into 12 categories based on the baseline HbA1c level. RESULTS: During 4 years, 601 of the 9723 subjects (6.2%) developed diabetes. Based on ROC analysis, a HbA1c of 5.7% gave an optimal sensitivity of 62% and specificity of 85% to predict diabetes. The point showing a substantial difference in the Kaplan-Meier curves was a HbA1c of 5.7%. The incidence of diabetes was 20.8% among subjects with a baseline HbA1c of 5.7-6.4%. The hazard ratio of developing diabetes was 6.5 (95% CI, 3.7-10.2) in the subjects with a HbA1c of 5.7% compared with the bottom category of HbA1c (<5.0%). CONCLUSIONS: A HbA1c cut-point of 5.7% is a suitable value for predicting future diabetes. It is reasonable to consider a HbA1c range of 5.7-6.4% as a category of increased risk for diabetes in Korean, similar to an IFG or IGT.
AIM: A glycated hemoglobin (HbA1c) range of 5.7-6.4% has been included as a category of increased risk for diabetes. We evaluated whether or not it is reasonable to apply this HbA1c range to Koreans. METHODS: A retrospective analysis was conducted among subjects who participated in comprehensive health check-ups annually for 5 years. A total of 9723 subjects were classified into 12 categories based on the baseline HbA1c level. RESULTS: During 4 years, 601 of the 9723 subjects (6.2%) developed diabetes. Based on ROC analysis, a HbA1c of 5.7% gave an optimal sensitivity of 62% and specificity of 85% to predict diabetes. The point showing a substantial difference in the Kaplan-Meier curves was a HbA1c of 5.7%. The incidence of diabetes was 20.8% among subjects with a baseline HbA1c of 5.7-6.4%. The hazard ratio of developing diabetes was 6.5 (95% CI, 3.7-10.2) in the subjects with a HbA1c of 5.7% compared with the bottom category of HbA1c (<5.0%). CONCLUSIONS: A HbA1c cut-point of 5.7% is a suitable value for predicting future diabetes. It is reasonable to consider a HbA1c range of 5.7-6.4% as a category of increased risk for diabetes in Korean, similar to an IFG or IGT.
Authors: Aaron Leong; Natalie Daya; Bianca Porneala; James J Devlin; Dov Shiffman; Michael J McPhaul; Elizabeth Selvin; James B Meigs Journal: Diabetes Care Date: 2017-10-26 Impact factor: 19.112