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HbA1c combined with glycated albumin or 1,5-anhydroglucitol improves the efficiency of diabetes screening in a Chinese population

Diabet Med. 2021 Sep 2:e14685. doi: 10.1111/dme.14685. Online ahead of print.

ABSTRACT

AIMS: This study aimed to evaluate the ability of HbA1c combined with glycated albumin (GA) or 1,5-anhydroglucitol (1,5-AG) to detect diabetes in residents of Jiangsu, China.

METHODS: The oral glucose tolerance test (OGTT) was performed on 2,184 people in Jiangsu. HbA1c, GA, 1,5-AG, and other serum biochemical parameters were measured. Receiver operating characteristic curves were plotted to determine the optimal thresholds of HbA1c, GA, and 1,5-AG according to the Youden index.

RESULTS: (1) The optimal thresholds of HbA1c, GA, and 1,5-AG for the screening of diabetes were ≥ 45 mmol/mol (6.3%), ≥ 13.0%, and ≤ 23.0 μg/ml, respectively. (2) The sensitivities of HbA1c combined with GA and 1,5-AG were both 85%, higher than that of HbA1c (70%, P < 0.001).

CONCLUSIONS: This study is suitable for cases where plasma glucose is unavailable. Among the residents of Jiangsu, HbA1c combined with GA or 1,5-AG can improve the sensitivity of diabetes screening, reduce the miss rate, and save the use of OGTT. GA and 1,5-AG are superior in individuals with mild glucose metabolism disorder. GA enhances the detection of diabetes in the nonobese, and 1,5-AG enhances the detection in those with hyperuricemia.

PMID:34473869 | DOI:10.1111/dme.14685

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