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

Diabet Med. 2022 Mar;39(3):e14685. doi: 10.1111/dme.14685. Epub 2021 Sep 26.

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 2184 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 hyperuricaemia.

Keywords: 1,5-anhydroglucitol; HbA1c; diabetes; glycated albumin; screening.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China
  • Cross-Sectional Studies
  • Deoxyglucose / blood*
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / diagnosis*
  • Female
  • Glucose Tolerance Test
  • Glycated Hemoglobin / analysis*
  • Glycated Serum Albumin
  • Glycation End Products, Advanced / analysis*
  • Humans
  • Hyperuricemia / blood
  • Hyperuricemia / diagnosis
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • ROC Curve
  • Sensitivity and Specificity
  • Serum Albumin / analysis*

Substances

  • Glycated Hemoglobin A
  • Glycation End Products, Advanced
  • Serum Albumin
  • 1,5-anhydroglucitol
  • Deoxyglucose
  • Glycated Serum Albumin