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2015, Number 1

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Rev Cub Med Mil 2015; 44 (1)

Glycated hemoglobin for diabetes mellitus diagnosis in preventive medical examinations

González TR, Aldama LIY, Fernández ML, Ponce BI, Rivero HMC, Jorin CN

Language: Spanish
References: 27
Page: 50-62
PDF size: 192.27 Kb.


ABSTRACT

Introduction: diabetes mellitus comprises a heterogeneous group of metabolic diseases characterized by hyperglycemia. Traditionally diagnosis was made through the determination of glucose in different circumstances: fasting, at random or during oral glucose tolerance; another tool for the diagnosis of this disease is glycosylated hemoglobin (hba1c).
Objective: evaluate the use of hba1c in the early diagnosis of diabetes mellitus in relation to fasting glucose.
Methods: cross-sectional study was conducted in 200 non-diabetic patients divided into two groups: hyperglycemic (fasting glucose ≥ 5.6 mmol/L; n= 99) and normoglycemic (fasting glucose ‹ 5,6 mmol /L; n= 100). They were classified after a program of study in nondiabetic patients (n= 101), pre-diabetic patients (n= 80) and diabetic patients (n= 19). Hba1c Pearson correlation coefficient and fasting plasma glucose was determined. Variances for each Hba1c group by one-way ANOVA were compared. Receiver operating curve for Hba1c convergence as diagnosis was used. Hba1c sensitivity, specificity, positive predictive value and negative predictive value and FPG for the glycemic status diagnosis were determined.
Results: correlation was found between HbA1c and fasting plasma glucose (r= 0.753; p= 0.000). The variance between each group was 0.752 by one-way ANOVA (p = 0.000). The area under the curve for diabetes mellitus diagnosis was 0.915 (p= 0.000). HbA1c for diabetes diagnosis had sensitivity (42.1 %), specificity (7.8 %), positive predictive value (66.7 %) and negative (94.1 %) predictive value.
Conclusions: individuals classified as diabetics with a HbA1c ≥ 6.5 % are different from those classified as such by the oral glucose tolerance test. HbA1c cutoff value ≥ 6.5 % is a useful tool to confirm the diagnosis of diabetes mellitus; however, it is not suitable for research studies.


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