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

B. M. Song, HyeonChang Kim, J. Y. Lee, J. M. Lee, D. J. Kim, Y. H. Lee, I. Suh

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1602-1610
Number of pages9
JournalDiabetic Medicine
Volume32
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

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Rural Population
Korea
Glucose
Fasting
Area Under Curve
Insulin
Waist Circumference
ROC Curve
Blood Glucose
Epidemiology
Triglycerides
Smoking
Alcohols
Genome
Exercise
Hypertension

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Song, B. M., Kim, H., Lee, J. Y., Lee, J. M., Kim, D. J., Lee, Y. H., & Suh, I. (2015). Performance of HbA1c for the prediction of diabetes in a rural community in Korea. Diabetic Medicine, 32(12), 1602-1610. https://doi.org/10.1111/dme.12794
Song, B. M. ; Kim, HyeonChang ; Lee, J. Y. ; Lee, J. M. ; Kim, D. J. ; Lee, Y. H. ; Suh, I. / Performance of HbA1c for the prediction of diabetes in a rural community in Korea. In: Diabetic Medicine. 2015 ; Vol. 32, No. 12. pp. 1602-1610.
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Song, BM, Kim, H, Lee, JY, Lee, JM, Kim, DJ, Lee, YH & Suh, I 2015, 'Performance of HbA1c for the prediction of diabetes in a rural community in Korea', Diabetic Medicine, vol. 32, no. 12, pp. 1602-1610. https://doi.org/10.1111/dme.12794

Performance of HbA1c for the prediction of diabetes in a rural community in Korea. / Song, B. M.; Kim, HyeonChang; Lee, J. Y.; Lee, J. M.; Kim, D. J.; Lee, Y. H.; Suh, I.

In: Diabetic Medicine, Vol. 32, No. 12, 01.12.2015, p. 1602-1610.

Research output: Contribution to journalArticle

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T1 - Performance of HbA1c for the prediction of diabetes in a rural community in Korea

AU - Song, B. M.

AU - Kim, HyeonChang

AU - Lee, J. Y.

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AU - Kim, D. J.

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N2 - 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.

AB - 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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