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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Main Authors: Jieun Lee, Young Ah Lee, Jae Hyun Kim, Seong Yong Lee, Choong Ho Shin, Sei Won Yang
Format: Article
Language:English
Published: Korean Diabetes Association 2019-04-01
Series:Diabetes & Metabolism Journal
Subjects:
Online Access:http://e-dmj.org/upload/pdf/dmj-43-174.pdf
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spelling 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
collection 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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