Annals of Clinical Biochemistry > Volume 45, Number 4 > Pp. 418-420

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Likhari, T. Articles by Gama, R Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?

Original Articles

Does HbA_1C predict isolated impaired fasting glycaemia in the oral glucose tolerance test in subjects with impaired fasting glycaemia?

Taruna Likhari¹, T S Aulakh², Baldev M Singh³ and R Gama^1,4

¹ Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP, UK; ² Outcome Centre, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY10 7AG, UK; ³ Department of Diabetes, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP, UK; ⁴ Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, West Midlands WV1 1SB, UK

Corresponding author: Dr Taruna Likhari, Department of Clinical Biochemistry, Manor Hospital, Walsall, West Midlands WS2 9PS, UK. Email: Taruna.likhari{at}walsallhospitals.nhs.uk

Background: To assess the usefulness of erythrocyte glycated haemoglobin (HbA_1C) as a screening tool to identify those subjects with impaired fasting glycaemia (IFG) who do not have impaired glucose tolerance (IGT) or diabetes mellitus (DM) on a 75 g oral glucose tolerance test (OGTT).

Design and methods: All subjects undergoing an OGTT had HbA_1C measured at baseline. Receiver operator characteristics analysis was used to identify optimal HbA_1C cut-off values for diagnosing and excluding IGT and DM.

Results: We studied 140 subjects (69 women) with IFG (fasting capillary plasma glucose between 6.1–6.9 mmol/L). Using World Health Organisation criteria, 27 had isolated IFG, 56 had IGT and 57 had DM. HbA_1C was higher (P < 0.001) in patients with DM (6.8 ± 0.93%) when compared with those with IGT (6.3 ± 0.68%) and isolated IFG (6.2 ± 0.30%), but HbA_1C was similar in those with IGT and isolated IFG. There was no HbA_1C cut-off value differentiating isolated IFG from IGT or DM. None of the subjects with isolated IFG had HbA_1C concentration of >6.8%, but 76% and 54% subjects with IGT and DM, respectively, had HbA_1C of 6.8%.

Conclusions: HbA_1C measurement is of limited value in differentiating isolated IFG, IGT and DM in subjects with IFG. It cannot be used to identify which subjects with IFG do not require an OGTT.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?