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Performance of HbA1c for the prediction of diabetes in a rural community in Korea

 B. M. Song  ;  H. C. Kim  ;  J. Y. Lee  ;  J.-M. Lee  ;  D. J. Kim  ;  Y.-H. Lee  ;  I. Suh 
 Diabetic Medicine, Vol.32(12) : 1602-1610, 2015 
Journal Title
 Diabetic Medicine 
Issue Date
Aged ; Biomarkers/blood ; Blood Glucose/analysis ; Cohort Studies ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/diagnosis* ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/ethnology ; Female ; Follow-Up Studies ; Glycated Hemoglobin A/analysis* ; Health Surveys ; Humans ; Incidence ; Insulin/blood ; Male ; Middle Aged ; Prediabetic State/blood ; Prediabetic State/diagnosis* ; Prediabetic State/epidemiology ; Prediabetic State/ethnology ; Predictive Value of Tests ; Prevalence ; Prospective Studies ; Republic of Korea/epidemiology ; Risk ; Rural Health*/ethnology ; Sensitivity and Specificity
AIM: To investigate the performance of HbA1c in predicting incident diabetes among Korean adults with normal fasting glucose and impaired fasting glucose levels. METHODS: This study used data from the Korean Genome Epidemiology Study-Kangwha Study. A prospective analysis was carried out on 2079 people (820 men and 1259 women) who completed follow-up examinations up until 2013. Diabetes was defined as fasting blood glucose level ≥ 7.0 mmol/l, HbA1c level ≥ 48 mmol/mol (6.5%), or current treatment for diabetes. Areas under the receiver-operating characteristic curves were used to assess the different performances of HbA1c , glucose and insulin in predicting diabetes. RESULTS: The median follow-up time was 3.97 years, during which 7.7% of men and 6.3% of women developed incident diabetes. The areas under the receiver-operating curves (95% CI) for diabetes prediction were 0.740 (0.692-0.787) for HbA1c , 0.716 (0.667-0.764) for glucose and 0.598 (0.549-0.648) for insulin. HbA1c showed better predictive power in people with impaired fasting glucose (area under the curve 0.753, 95% CI 0.685-0.821) than in those with normal glucose (area under the curve 0.648, 95% CI 0.577-0.719). An HbA1c threshold of 40 mmol/mol (5.8%) was found to have the highest predictive value for diabetes, with a relative risk of 6.30 (95% CI 3.49-11.35) in men and 3.52 (95% CI 2.06-6.03) in women after adjusting for age, waist circumference, triglycerides, hypertension, family history of diabetes, smoking, alcohol intake, exercise and baseline glucose level. CONCLUSIONS: HbA1c can be used to identify people at high risk for the development of diabetes, especially in those with impaired fasting glucose levels.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김현창(Kim, Hyeon Chang) ORCID logo https://orcid.org/0000-0001-7867-1240
서일(Suh, Il) ORCID logo https://orcid.org/0000-0002-9689-7849
송보미(Song, Bo Mi)
이용호(Lee, Yong Ho) ORCID logo https://orcid.org/0000-0002-6219-4942
이주미(Lee, Ju Mi)
이주영(Lee, Joo Young)
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