Increased Hemoglobin A1c Threshold for Prediabetes Remarkably Improving the Agreement Between A1c and Oral XXXX Tolerance Test Criteria in Obese Population.

@entity1 @entity28 @entity6 @entity5710 @entity413
CONTEXT: It is unclear why the prevalence of @entity6 and @entity5710 , especially @entity5710 , between diagnosed by oral @entity413 tolerance test (OGTT) and hemoglobin A1c (HbA1c) criteria, is substantially discordant. OBJECTIVE: We aimed to evaluate the effects of @entity28 on the agreement between HbA1c and OGTT for diagnosing @entity6 and @entity5710 and identify the optimal HbA1c cutoff values in different body mass index (BMI) classifications. DESIGN SETTING AND @entity1 : In a population-based, cross-sectional study in Harbin, China, 4325 individuals aged 20-74 years without a prior diagnosed @entity6 were involved in this study. OUTCOME: measure The performance and optimal cutoff points of HbA1c were assessed by receiver-operating characteristic curve. The contribution of BMI to HbA1c was analyzed by structural equational model. RESULTS: The agreement between HbA1c criteria and OGTT decreased with BMI gain (k = 0.359, 0.312, and 0.275 in a normal weight, overweight, and @entity28 population, respectively). The structural equational model results showed that BMI was significantly associated with HbA1c in normal @entity413 tolerance and @entity5710 subjects but not in @entity6 subjects. At a specificity of 80% for @entity5710 and 97.5% for @entity6 , the optimal HbA1c cutoff points for @entity5710 and @entity6 were 5.6% and 6.4% in normal-weight, 5.7% and 6.5% in overweight, and 6.0% and 6.5% in an @entity28 population. When the new HbA1c cutoff values were used, the agreement in @entity28 subjects increased almost to the level in normal-weight subjects. CONCLUSIONS: The poor agreement between HbA1c and OGTT criteria in an @entity28 population can be significantly improved through increasing the HbA1c threshold for @entity5710 .
