HbA1c, fasting plasma glucose and the prediction of diabetes: Inter99, AusDiab and D.E.S.I.R.

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• 作者：Soraya Soulimane^a ; ^b ; ^{soraya.soulimane@inserm.fr} ; Dominique Simon^a ; ^c ; Jonathan Shaw^d ; Daniel Witte^e ; Paul Zimmet^d ; Sylviane Vol^f ; Knut Borch-Johnsen^g ; Dianna Magliano^d ; Dorte Vistisen^e ; Beverley Balkau^a ; ^b ; ^d
• 关键词：FPG ; fasting plasma glucose ; IFG ; impaired fasting glucose ; PPV ; positive predictive value
• 刊名：Diabetes Research and Clinical Practice
• 出版年：2012
• 期刊代码：78_01688227
• 类别：med
• 出版时间：June, 2012
• 卷：96
• 期：3
• 页码：392-399
• 文件大小：353 K

摘要

Introduction

With diabetes defined by HbA1c 鈮?#xA0;6.5%and/or FPG 鈮?#xA0;7.0 mmol/l and/or diabetes treatment, we investigated HbA1c and fasting plasma glucose (FPG) thresholds/change-points above which the incidence of diabetes increases.

Methods

Data are Danish (Inter99), Australian (AusDiab) and French (D.E.S.I.R.), with respectively 4930, 6012 and 3784 non-diabetic participants.

Results

Diabetes incidences at 5 years for Inter99 and AusDiab and at 6 years for D.E.S.I.R. were 2.3%, 3.1%and 2.4%respectively and incidences increased with baseline HbA1c and FPG. As HbA1c distributions differed between cohorts, HbA1c was standardized on D.E.S.I.R. data. Change-points where diabetes incidence increased were identified for HbA1c (%) after standardization: 5.1 (4.9-5.6) (Inter99), 5.4 (5.1-5.6) (AusDiab), 5.3 (5.1-5.7) (D.E.S.I.R.); for FPG change-points (mmol/l) were 5.1 (鈥︹€?.1) (Inter99), 5.5 (5.2-5.8) (AusDiab), no change-point for D.E.S.I.R. Using current diabetes risk criteria HbA1c 鈮?#xA0;5.7%and/or FPG 鈮?#xA0;5.6 mmol/l to screen for diabetes provided high sensitivity (over 89%) and positive predictive values: 4.3%, 6.9%, and 5.9%respectively.

Conclusions

HbA1c and FPG change-points predicting incident diabetes did not always exist, differed across studies, when available were generally lower than current criteria with wide confidence intervals. Using jointly HbA1c 鈮?#xA0;5.7%and/or FPG 鈮?#xA0;5.6 mmol/l as a criterion for the risk of incident diabetes is appropriate.