Prediabetes defined by HbA1c and by fasting glucose: differences in risk factors and prevalence

Rodrı́guez-Segade, Santiago; Rodríguez, Juan Enrique Arias; Camiña, Félix; Sanmartín-Portas, Luís; Gerpe-Jamardo, Josefa; Pazos-Couselo, Marcos; García-López, José Manuel; Alonso-Sampedro, Manuela; González‐Quintela, Arturo; Gude‐Sampedro, Francisco

doi:10.1007/s00592-019-01342-5

Cited by 10 publications

(10 citation statements)

References 35 publications

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“…In agreement with previous studies [37,38,39], we found that hypertension and hearing loss were significantly higher among prediabetic adults. The development of comorbidities in prediabetic adults has become a point of concern for the scientific community, leading to continued research in the area in order to better understand the development of such complications, their treatment, and possible health-related consequences among prediabetic adults.…”

Section: Discussionsupporting

confidence: 93%

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study

et al. 2019

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This study evaluated the predictive ability of 11 obesity- and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), “A” body-shape index (ABSI), conicity index (C), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles (p < 0.001). The TyG index was best able to identify prediabetes in either sex (AUC and optimal cut-off = 0.700 and 8.72, and 0.695 and 8.92 for men and women, respectively), suggesting that compared to the other parameters, the TyG index has the best discriminative power to predict prediabetes in the whole population. Thus, we propose the TyG index be used as a complementary marker for assessing prediabetes in older adults.

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Section: Discussionsupporting

confidence: 93%

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study

et al. 2019

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“…In this research, the prevalence of pre-diabetes using HbA 1c ADA cut-offs was 33.1% compared 13.3% using FPG ADA cut-points [ 9 ]. Results consistent with our findings were also found in a Spanish study (21.7% using HbA 1c vs. 16.3% using FPG) [ 57 ] and one conducted in Palestine (45.8% using HbA 1c vs. 24.6% using FPG) [ 23 ]. In contrast, some studies have found a higher prevalence among those diagnosed with FPG compared to those identified using HbA 1c .…”

Section: Discussionsupporting

confidence: 92%

“…As previously discussed, discordance in pre-diabetes prevalence estimates according to diagnostic criteria is well-documented [ 7 , 23 , 57 ] and was also noted in the first wave analysis of the Mitchelstown Cohort in 2010/11, where pre-diabetes prevalence was found to be 49.1% and 11.5% using HbA 1c ADA and FPG ADA thresholds, respectively [ 6 ]. A higher prevalence using HbA 1c was also found in a Canadian study published in 2015.…”

Section: Discussionmentioning

confidence: 89%

The prevalence and correlates of pre-diabetes in middle- to older-aged Irish adults using three diagnostic methods

et al. 2021

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Background and objectives Type 2 diabetes is a leading cause of death and disability worldwide and pre-diabetes is a strong predictor of diabetes development. To date, studies estimating the prevalence of pre-diabetes in the Irish population are sparse and conflicting. Monitoring the prevalence of pre-diabetes and a knowledge of associated factors is required to inform policies and to prevent development of type 2 diabetes. Therefore, this research examined the prevalence and correlates of pre-diabetes in a sample of middle- to older-aged Irish adults using three different methods for diagnosis. Materials and methods The Mitchelstown Cohort Rescreen (2016/17) was a follow-up, cross-sectional study of the Mitchelstown Cohort Study (2010/11). 1,378 participants were recruited from a random sample of patients attending a single primary care centre. Pre-diabetes was defined using three diagnostic criteria: American Diabetes Association (ADA) glycated haemoglobin A1c (HbA1c) cut-offs between 5.7%–6.4% (39–46 mmol/mol), World Health Organization International Expert Committee (WHO-IEC) HbA1c cut-offs between 6.0%–6.4% (42–46 mmol/mol) and ADA fasting plasma glucose (FPG) cut-offs between 5.6–6.9 mmol/l. Univariate and multivariable logistic regression analyses were used to determine factors associated with pre-diabetes. Results The prevalence of pre-diabetes was found to be 43.9% (95% CI: 41.2%─46.5%), 14.5% (95% CI: 12.7%─16.5%) and 15.8% (95% CI: 13.9%─17.8%) according to HbA1c ADA, HbA1c WHO-IEC and FPG ADA definitions, respectively. Depending on diagnostic method, factors associated with pre-diabetes in univariate analyses included sex, age, marital status, health rating, education and poor diet quality. In multivariable analysis, subjects classified by the FPG ADA pre-diabetes criterion displayed the least optimal metabolic profile defined by overweight and obesity (OR = 2.88, 95% CI: 1.53–5.43), hypertension (OR = 2.27, 95% CI: 1.51–3.40) and low high-density lipoprotein cholesterol concentrations (OR = 1.75, 95% CI: 1.07–2.87). Conclusions The discordance between prevalence estimates according to method of diagnosis is concerning. A National Diabetes Prevention Programme is currently being developed in Ireland. Monitoring the prevalence of pre-diabetes over time will be important to assess the effectiveness of this programme. This study will inform national decision-makers on which definition of pre-diabetes to use for monitoring purposes.

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“…In the Insulin Resistance Atherosclerosis Study [32], the sensitivity of HbA1c criteria (5.7% to 6.4%) for prediabetes increased with increasing BMI (67.8% in obese subjects [BMI ≥30 kg/m 2 ] vs. 19.9% in overweight subjects [BMI 25.0 to 29.9 kg/m 2 ]), but this trend was not observed in IGT criteria (60.0% in obese subjects vs. 58.1% in overweight subjects). In the Spanish non-diabetic community study, the prevalence of prediabetes was affected by BMI when the HbA1c criteria was applied but not in FPG criteria [33]. A pooled analysis of global surveillance of diabetes prevalence showed that the relationship between glucose-based and HbA1c-based prevalence of diabetes was partly related to participants' age and the presence of obesity, and the prevalence based on HbA1c increased with age, national income, and mean BMI [34].…”

Section: Discussionmentioning

confidence: 99%

Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity

Yoo¹,

Jung²,

Kim³

et al. 2020

Endocrinol Metab

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Background: To examine whether glycated hemoglobin (HbA1c) test would be a suitable screening tool for detecting high-risk subjects for diabetes compared to oral glucose tolerance test (OGTT) according to accompanied central obesity.Methods: In this prospective population-based cohort study, both OGTT and HbA1c tests were performed and continued every 2 years up to 12 years among individuals with non-diabetic state at baseline (aged 40 to 69 years, n=7,512). Incident diabetes was established by a doctor, HbA1c ≥6.5%, and/or fasting plasma glucose (FPG) ≥126 mg/dL, and/or 2-hour postprandial glucose (2hPG) level based on OGTT ≥200 mg/dL. Discriminative capacities of high HbA1c (≥5.7%) versus high 2hPG (≥140 mg/dL) for predicting incident diabetes were compared using Cox-proportional hazard regression and C-index.Results: During the median 11.5 years of follow-up period, 1,341 (17.6%) developed diabetes corresponding to an incidence of 22.1 per 1,000 person-years. Isolated high 2hPG was associated with higher risk for incident diabetes (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.56 to 5.17) than isolated high HbA1c (HR, 2.79; 95% CI, 2.40 to 3.26; P<0.05). In addition, high 2hPG provided better discriminatory capacity than high HbA1c (C-index 0.79 vs. 0.75, P<0.05). Meanwhile, in subjects with central obesity, the HR (3.95 [95% CI, 3.01 to 5.18] vs. 2.82 [95% CI, 2.30 to 3.46]) and discriminatory capacity of incident diabetes (C-index 0.75 vs. 0.75) between two subgroups became comparable.Conclusion: Even though the overall inferior predictive capacity of HbA1c test than OGTT, HbA1c test might plays a complementary role in identifying high risk for diabetes especially in subjects with central obesity with increased sensitivity.

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Prediabetes defined by HbA1c and by fasting glucose: differences in risk factors and prevalence

Cited by 10 publications

References 35 publications

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study

The prevalence and correlates of pre-diabetes in middle- to older-aged Irish adults using three diagnostic methods

Predictive Performance of Glycated Hemoglobin for Incident Diabetes Compared with Glucose Tolerance Test According to Central Obesity

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