Evaluation of Glycated Hemoglobin (HbA1c) for Diagnosing Type 2 Diabetes and Prediabetes among Palestinian Arab Population
Date
2014-02-05
Authors
Kharroubi, Akram T.
Darwish, Hisham M.
Abu Al-Halaweh, Ahmad I.
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
The purpose of the study is to compare the potential of HbA1c to diagnose diabetes among Palestinian Arabs compared to
fasting plasma glucose (FPG). A cross-sectional sample of 1370 Palestinian men (468) and women (902) without known
diabetes and above the age of 30 years were recruited. Whole blood was used to estimate HbA1c and plasma for FPG and
total lipid profile. Fasting plasma glucose was used as a reference to diagnose diabetes ($ 126 mg/dL) and prediabetes
(100–125 mg/dL). The area under the receiver operating characteristic curve (AUC) for HbA1c was 81.9% to diagnose
diabetes and 63.9% for prediabetes. The agreement between HbA1c and diabetes as diagnosed by FPG was moderate (K =
0.498) and low with prediabetes (K = 0.142). The optimal cut-off value for HbA1c to diagnose diabetes was $ 6.3%
(45 mmol/mol). The sensitivity, specificity and the discriminant ability were 65.6% (53.1–76.3%), 94.5% (93.1–95.6%), 80.0%
(72.8–87.3%), respectively. However, using cut-off value of $ 6.5% (48 mmol/mol) improved specificity. At this cut-off value,
the sensitivity, specificity and the discriminant ability were 57.4% (44.9–69.0%), 97.1% (96.0–97.9%) and 77.3% (71.0–83.5%).
For diagnosing prediabetes with HbA1c between 5.7–6.4% (39–46 mmol/mol), the sensitivity, specificity and the
discriminant ability were 62.7% (57.1–67.9%), 56.3% (53.1–59.4%) and 59.5% (56.3–62.5%), respectively. HbA1c at cut-off
value of $ 6.5% (48 mmol/mol) by itself diagnosed 5.3% and 48.3% as having diabetes and prediabetes compared to 4.5%
and 24.2% using FPG, respectively. Mean HbA1c and FPG increase significantly with increasing body mass index. In
conclusion, the ROC curves showed HbA1c could be used for diagnosing diabetes when compared to FPG but not for
prediabetes in Palestinians Arabs even though only about 50% of the diabetic subjects were identified by the both HbA1c
and FPG.
Description
Keywords
Citation
Kharroubi AT, Darwish HM, Abu Al-Halaweh AI, Khammash UM (2014) Evaluation of Glycated Hemoglobin (HbA1c) for Diagnosing Type 2 Diabetes and Prediabetes among Palestinian Arab Population. PLoS ONE 9(2): e88123. doi:10.1371/journal.pone.0088123