Fasting plasma glucose and HbA1c as a screening test for diabetes mellitus
- VernacularTitle:空腹血糖和糖化血红蛋白用于筛查糖尿病的研究
- Author:
Xianghai ZHOU
;
Linong JI
- Publication Type:Journal Article
- Keywords:
Fasting plasma glucose;
HbA1c;
Oral glucose tolerance test;
Diabetes mellitus;
Receiver operator characteristic curve (ROC curve)
- From:
Chinese Journal of Diabetes
2005;13(3):203-205
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the validity of using fasting plasma glucose （FPG） and HbA1c for the screening of diabetes. Methods 1118 subjects （489 men, 629 women） in Beijing area underwent an oral glucose tolerance test （OGTT） for screening diabetes. HbA1c was examined at the same time. They have never undergone OGTT and controlled plasma glucose levels by any methods. Their average age was 48±12 years. Results Using 1999 WHO criteria, 510 had normal glucose tolerance （NGT）, 35 had impaired fasting glucose（IFG）, 155 had impaired glucose tolerance （IGT）, 52 had IGT and IFG, 366 had diabetes. Using a receiver operating characteristic curve （ROC curve）, the optimal cut-point of FPG related to diabetes diagnosed by OGTT was 6.2mmol/L that was associated with a sensitivity and specificity of 85.0% and 90.4% respectively. Area under the curve was 0.943 （95% CI 0.9270.959）, a positive likelihood ratio （LR） was 8.9, and a negative LR was 0.2. The optimal cut-point of HbA1c related to diabetes diagnosed by OGTT was 6.2%, which was associated with a sensitivity and specificity of 86.6% and 77.5% respectively. Area under the curve was 0.896 （95% CI 0.8760.916）, a positive LR was 3.9, and a negative LR was 0.2. The cut-point of FPG related to IGT diagnosed by OGTT was 5.1 mmol/L, which was associated with a sensitivity and specificity of 65.2% and 68.3% respectively. Area under the curve was 0.729 （95% CI 0.6890.769）, a positive LR was 2.1, and a negative LR was 0.5. The cut-point of HbA1c related to IGT diagnosed by OGTT was 5.7%, which was associated with a sensitivity and specificity of 63.3% and 56.5% respectively. Area under the curve was 0.634 （95% CI 0.5910.677）, a positive LR was 1.5, and a negative LR was 0.7. Conclusions When FPG<7.0 mmol/L and ≥6.2 mmol/L or HbA1c≥6.2%, OGTT was necessary to confirm the diagnosis of diabetes. FPG or HbA1c was not reliable to identify IGT.
