Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults
BackgroundGlycosylated hemoglobin (HbA1c) has been recommended as a diagnostic test for prediabetes and diabetes. Here, we evaluated the level of agreement between diagnoses based on fasting plasma glucose (FPG) versus HbA1c levels and determined optimal HbA1c cutoff values for these diseases in you...
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doaj-368f9ea97b604bc48a62a99682138c912020-11-25T04:08:01ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872019-04-0143217418210.4093/dmj.2018.0046614Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young AdultsJieun Lee0Young Ah Lee1Jae Hyun Kim2Seong Yong Lee3Choong Ho Shin4Sei Won Yang5Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, .KoreaDepartment of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, .KoreaDepartment of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, .KoreaDepartment of Pediatrics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, .KoreaDepartment of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, .KoreaDepartment of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, .KoreaBackgroundGlycosylated hemoglobin (HbA1c) has been recommended as a diagnostic test for prediabetes and diabetes. Here, we evaluated the level of agreement between diagnoses based on fasting plasma glucose (FPG) versus HbA1c levels and determined optimal HbA1c cutoff values for these diseases in youth and young adults.MethodsThe study included 7,332 subjects (n=4,129, aged 10 to 19 years in youth group; and n=3,203 aged 20 to 29 years in young adult group) from the 2011 to 2016 Korea National Health and Nutrition Examination Survey. Prediabetes and diabetes were defined as 100 to 125 mg/dL (impaired fasting glucose [IFG]) and ≥126 mg/dL for FPG (diabetes mellitus [DM] by FPG [DMFPG]), and 5.7% to 6.4% and ≥6.5% for HbA1c, respectively.ResultsIn the youth group, 32.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 72.2% with DMFPG had an HbA1c ≥6.5%. In the young adult group, 27.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 66.6% with DMFPG had an HbA1c ≥6.5%. Kappa coefficients for agreement between the FPG and HbA1c results were 0.12 for the youth group and 0.19 for the young adult group. In receiver operating characteristic curve analysis, the optimal HbA1c cutoff for IFG and DMFPG were 5.6% and 5.9% in youths and 5.5% and 5.8% in young adults, respectively.ConclusionUsefulness of HbA1c for diagnosis of IFG and DMFPG in Koreans aged <30 years remains to be determined due to discrepancies between the results of glucose- and HbA1c-based tests. Additional testing might be warranted at lower HbA1c levels to detect IFG and DMFPG in this age group.http://e-dmj.org/upload/pdf/dmj-43-174.pdfadolescentblood glucosediabetes mellitusdiagnosisglycated hemoglobin aprediabetic stateyoung adult |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jieun Lee Young Ah Lee Jae Hyun Kim Seong Yong Lee Choong Ho Shin Sei Won Yang |
spellingShingle |
Jieun Lee Young Ah Lee Jae Hyun Kim Seong Yong Lee Choong Ho Shin Sei Won Yang Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults Diabetes & Metabolism Journal adolescent blood glucose diabetes mellitus diagnosis glycated hemoglobin a prediabetic state young adult |
author_facet |
Jieun Lee Young Ah Lee Jae Hyun Kim Seong Yong Lee Choong Ho Shin Sei Won Yang |
author_sort |
Jieun Lee |
title |
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults |
title_short |
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults |
title_full |
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults |
title_fullStr |
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults |
title_full_unstemmed |
Discrepancies between Glycosylated Hemoglobin and Fasting Plasma Glucose for Diagnosing Impaired Fasting Glucose and Diabetes Mellitus in Korean Youth and Young Adults |
title_sort |
discrepancies between glycosylated hemoglobin and fasting plasma glucose for diagnosing impaired fasting glucose and diabetes mellitus in korean youth and young adults |
publisher |
Korean Diabetes Association |
series |
Diabetes & Metabolism Journal |
issn |
2233-6079 2233-6087 |
publishDate |
2019-04-01 |
description |
BackgroundGlycosylated hemoglobin (HbA1c) has been recommended as a diagnostic test for prediabetes and diabetes. Here, we evaluated the level of agreement between diagnoses based on fasting plasma glucose (FPG) versus HbA1c levels and determined optimal HbA1c cutoff values for these diseases in youth and young adults.MethodsThe study included 7,332 subjects (n=4,129, aged 10 to 19 years in youth group; and n=3,203 aged 20 to 29 years in young adult group) from the 2011 to 2016 Korea National Health and Nutrition Examination Survey. Prediabetes and diabetes were defined as 100 to 125 mg/dL (impaired fasting glucose [IFG]) and ≥126 mg/dL for FPG (diabetes mellitus [DM] by FPG [DMFPG]), and 5.7% to 6.4% and ≥6.5% for HbA1c, respectively.ResultsIn the youth group, 32.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 72.2% with DMFPG had an HbA1c ≥6.5%. In the young adult group, 27.5% with IFG had an HbA1c level of 5.7% to 6.4%, and 66.6% with DMFPG had an HbA1c ≥6.5%. Kappa coefficients for agreement between the FPG and HbA1c results were 0.12 for the youth group and 0.19 for the young adult group. In receiver operating characteristic curve analysis, the optimal HbA1c cutoff for IFG and DMFPG were 5.6% and 5.9% in youths and 5.5% and 5.8% in young adults, respectively.ConclusionUsefulness of HbA1c for diagnosis of IFG and DMFPG in Koreans aged <30 years remains to be determined due to discrepancies between the results of glucose- and HbA1c-based tests. Additional testing might be warranted at lower HbA1c levels to detect IFG and DMFPG in this age group. |
topic |
adolescent blood glucose diabetes mellitus diagnosis glycated hemoglobin a prediabetic state young adult |
url |
http://e-dmj.org/upload/pdf/dmj-43-174.pdf |
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