You-Cheol Hwang1, Chang Hee Jung2, Hong-Yup Ahn3, Won Seon Jeon4, Sang-Man Jin5, Jeong-Taek Woo1, Bong Soo Cha6, Jae Hyeon Kim5, Cheol-Young Park7, Byung-Wan Lee6. 1. Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 2. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 3. Department of Statistics, Dongguk University, Seoul, Republic of Korea. 4. Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea. 5. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Division of Endocrinology and Metabolism, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 7. Division of Endocrinology and Metabolism, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea. Electronic address: cydoctor@chol.com.
Abstract
INTRODUCTION: Glycated albumin (GA) reflects short-term status of glycemic control. We suggest a GA cut-off value to diagnose pre-diabetes and diabetes in Korean adults. In addition, we compared the performance of GA for the diagnosis of diabetes with that of glycated hemoglobin (A1c). MATERIALS AND METHODS: A total of 852 subjects (498 males, 354 females) aged 20 to 83years (mean: 52.5years) were enrolled. A 75-g oral glucose tolerance test (OGTT) was performed and A1c and GA were measured. RESULTS: In these enrolled subjects, 88% have glucose intolerance status (pre-diabetes or diabetes). The GA concentrations corresponding to fasting plasma glucose (FPG) of 7.0mmol/l, 2-h plasma glucose during OGTT (PPG2)≥11.1mmol/l, and A1c≥6.5% were 14.6%, 13.7%, and 14.7%, respectively. A meta-analysis of three GA cutoffs revealed a GA cutoff for diabetes of 14.3%. When A1c is used in combination with FPG, the sensitivity and specificity for the diagnosis of OGTT-based diabetes were 72.16% (95% CI: 66.6-72.2) and 96.4% (95% CI: 94.4-97.7), respectively. With the newly developed GA cutoff of 14.3%, GA combined with FPG resulted in a sensitivity and specificity of 77.5% (95% CI: 72.17-82.0) and 89.9% (95% CI: 87.1-92.2), respectively. CONCLUSIONS: A GA cutoff of >14.3% is optimal for the diagnosis of diabetes in Korean adults. The measurement of FPG and GA may detect diabetes earlier than the measurement of FPG and A1c.
INTRODUCTION: Glycated albumin (GA) reflects short-term status of glycemic control. We suggest a GA cut-off value to diagnose pre-diabetes and diabetes in Korean adults. In addition, we compared the performance of GA for the diagnosis of diabetes with that of glycated hemoglobin (A1c). MATERIALS AND METHODS: A total of 852 subjects (498 males, 354 females) aged 20 to 83years (mean: 52.5years) were enrolled. A 75-g oral glucose tolerance test (OGTT) was performed and A1c and GA were measured. RESULTS: In these enrolled subjects, 88% have glucose intolerance status (pre-diabetes or diabetes). The GA concentrations corresponding to fasting plasma glucose (FPG) of 7.0mmol/l, 2-h plasma glucose during OGTT (PPG2)≥11.1mmol/l, and A1c≥6.5% were 14.6%, 13.7%, and 14.7%, respectively. A meta-analysis of three GA cutoffs revealed a GA cutoff for diabetes of 14.3%. When A1c is used in combination with FPG, the sensitivity and specificity for the diagnosis of OGTT-based diabetes were 72.16% (95% CI: 66.6-72.2) and 96.4% (95% CI: 94.4-97.7), respectively. With the newly developed GA cutoff of 14.3%, GA combined with FPG resulted in a sensitivity and specificity of 77.5% (95% CI: 72.17-82.0) and 89.9% (95% CI: 87.1-92.2), respectively. CONCLUSIONS: A GA cutoff of >14.3% is optimal for the diagnosis of diabetes in Korean adults. The measurement of FPG and GA may detect diabetes earlier than the measurement of FPG and A1c.
Authors: Michael Bergman; Muhammad Abdul-Ghani; Ralph A DeFronzo; Melania Manco; Giorgio Sesti; Teresa Vanessa Fiorentino; Antonio Ceriello; Mary Rhee; Lawrence S Phillips; Stephanie Chung; Celeste Cravalho; Ram Jagannathan; Louis Monnier; Claude Colette; David Owens; Cristina Bianchi; Stefano Del Prato; Mariana P Monteiro; João Sérgio Neves; Jose Luiz Medina; Maria Paula Macedo; Rogério Tavares Ribeiro; João Filipe Raposo; Brenda Dorcely; Nouran Ibrahim; Martin Buysschaert Journal: Diabetes Res Clin Pract Date: 2020-06-01 Impact factor: 5.602
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