Moving to an A1C-Based Diagnosis of Diabetes Has a Different Impact on Prevalence in Different Ethnic Groups

被引:135
作者
Christensen, Dirk L. [1 ,2 ]
Witte, Daniel R. [1 ]
Kaduka, Lydia [3 ]
Jorgensen, Marit E. [4 ,5 ]
Borch-Johnsen, Knut [1 ,6 ]
Mohan, Viswanathan [7 ,8 ]
Shaw, Jonathan E. [9 ]
Tabak, Adam G. [10 ,11 ]
Vistisen, Dorte [1 ]
机构
[1] Steno Diabet Ctr, DK-2820 Gentofte, Denmark
[2] Univ Copenhagen, Dept Int Hlth Immunol & Microbiol, Copenhagen, Denmark
[3] KEMRI, Ctr Publ Hlth Res, Nairobi, Kenya
[4] Univ So Denmark, Ctr Hlth Res Greenland, Directorate Hlth, Copenhagen, Denmark
[5] Univ So Denmark, Natl Inst Publ Hlth, Copenhagen, Denmark
[6] Glostrup Cty Hosp, Res Ctr Prevent & Hlth, Copenhagen, Denmark
[7] World Hlth Org Collaborating Ctr Noncommunicable, Madras Diabet Res Fdn, Madras, Tamil Nadu, India
[8] World Hlth Org Collaborating Ctr Noncommunicable, Dr Mohans Diabet Special Ctr, Madras, Tamil Nadu, India
[9] Baker IDI Heart & Diabet Inst, Caulfield, Vic, Australia
[10] UCL, Dept Epidemiol & Publ Hlth, London, England
[11] Semmelweis Univ, Dept Internal Med 1, Fac Med, H-1085 Budapest, Hungary
基金
英国医学研究理事会;
关键词
GLUCOSE; A1C;
D O I
10.2337/dc09-1843
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - To compare screen-detected diabetes prevalence and the degree of diagnostic agreement by ethnicity with the current Oral glucose tolerance test (OGTT)-based and newly proposed A1C-based diagnostic criteria. RESEARCH DESIGN AND METHODS - Six studies (1999-2009) from Denmark, the U.K., Australia, Greenland, Kenya, and India were tested for the probability of an A1C >= 6.5% among diabetic case subjects based on an OGTT. The difference in probability between centers was analyzed by logistic regression adjusting for relevant confounders. RESULTS - Diabetes prevalence was lower with the A1C-based diagnostic Criteria in four of six studies. The probability of an A1C >= 6.5% among OGTT-diagnosed case subjects ranged widely (17.0-78.0%) by Study center. Differences in diagnostic agreement between ethnic subgroups in the U.K. Study were of the same magnitude as between-country comparisons. CONCLUSIONS - A shift to an A1C-based diagnosis for diabetes will have substantially different consequences for diabetes prevalence across ethnic groups and populations.
引用
收藏
页码:580 / 582
页数:3
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