Cutoff Point of HbA1c for Diagnosis of Diabetes Mellitus in Chinese Individuals

PLoS One. 2016 Nov 18;11(11):e0166597. doi: 10.1371/journal.pone.0166597. eCollection 2016.

Abstract

Background: The purpose of the present study was to find the optimal threshold of glycated hemoglobin (HbA1c) for diagnosis of diabetes mellitus in Chinese individuals.

Methods: A total of 8 391 subjects (including 2 133 men and 6 258 women) aged 40-90 years with gradable retinal photographs were recruited. The relationship between HbA1c and diabetic retinopathy (DR) was examined. Receiver operating characteristic (ROC) curves were used to find the optimal threshold of HbA1c in screening DR and diagnosing diabetes.

Results: HbA1c values in patients with DR were significantly higher than in those with no DR. The ROC curve for HbA1c had an area under the curve of 0.881 (95%CI 0.857-0.905; P = 0.000). HbA1c at a cutoff of 6.5% had a high sensitivity (80.6%) and specificity (86.9%) for detecting DR.

Conclusions: HbA1c can be used to diagnose diabetes in a Chinese population, and the optimal HbA1c cutoff point for diagnosis is 6.5%.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People*
  • Blood Glucose
  • China / epidemiology
  • Comorbidity
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / epidemiology
  • Female
  • Glycated Hemoglobin*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Population Surveillance
  • Prevalence
  • ROC Curve
  • Reference Values
  • Reproducibility of Results
  • Risk Factors

Substances

  • Blood Glucose
  • Glycated Hemoglobin A

Grants and funding

This study was supported by grant 2013BAI09B13 from the China National Clinical Research Center for Metabolic Diseases. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.