Abstract | BACKGROUND: Positive predictive value (PPV) of hemoglobin A1c (HbA1c) for diagnosis of prediabetes in clinical practice has not been well studied. METHODS: In a prospective study, patients diagnosed with prediabetes based on HbA1c (5.7%-6.4%) underwent a 75-g oral glucose tolerance test (OGTT) as the gold standard test to diagnose dysglycemia. Demographics, anthropometrics, comorbidity, concomitant prescription medications and biochemical data were collected. RESULTS: We identified 66 patients with HbA1c-based prediabetes with a mean HbA1c of 6.00 ± 0.20%. However, based on the OGTT, 32 had normal glucose tolerance (NGT), 26 had prediabetes and 8 had diabetes yielding a PPV of HbA1c of 39.4%. In univariate analysis, the patients with the OGTT-based prediabetes administered more medications for associated medical problems compared with the NGT group (5.9 ± 2.2 versus 2.6 ± 1.8, P < 0.0001). After adjustment for baseline variables, the medication use remained significantly different between OGTT-based prediabetes and NGT groups (P = 0.041). CONCLUSIONS: PPV of HbA1c for diagnosis of prediabetes in clinical setting is low. Patients with HbA1c of 5.7% to 6.4% should undergo OGTT to confirm diagnosis of dysglycemia.
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Authors | Aidar R Gosmanov, Jim Wan |
Journal | The American journal of the medical sciences
(Am J Med Sci)
Vol. 348
Issue 3
Pg. 191-4
(Sep 2014)
ISSN: 1538-2990 [Electronic] United States |
PMID | 24556928
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Blood Glucose
- Glycated Hemoglobin A
- hemoglobin A1c protein, human
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Topics |
- Adult
- Aged
- Biomarkers
(blood)
- Blood Glucose
(metabolism)
- Cross-Sectional Studies
- Female
- Glucose Tolerance Test
(standards)
- Glycated Hemoglobin
(metabolism)
- Humans
- Male
- Middle Aged
- Prediabetic State
(blood, diagnosis)
- Predictive Value of Tests
- Prospective Studies
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