Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus?

Dilek Geneş; Zafer Pekkolay; Coşkun Beyaz; Faruk Kılınç; Alpaslan Kemal Tuzcu

doi:10.5798/dicletip.706051

Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus?

Öz

Objective: The present study aimed to investigate the efficacy of hemoglobin A1c (HbA1c) in diagnosing type 2 diabetes and to introduce a new approach to oral glucose tolerance test (OGTT). Methods: This retrospective cross-sectional study included 560 subjects (363 females, 197 males) with a mean age of 46.7±12.9 years. These subjects underwent a standard 75-g OGTT, plasma glucose levels were assayed at 0, 30, 60, 90, and 120 minutes in 232 subjects who consented to these tests, and the area under the curve (AUC) was calculated. HbA1c levels were also measured simultaneously. The receiver operating characteristics (ROC) curve was used to determine the sensitivity and specificity of certain HbA1c cut-off values in diagnosing diabetes in subjects who underwent OGTT. Chi-square test was used for data comparisons, and Pearson’s correlation coefficient was used to evaluate the relationship between the measurements. Results: Among the 560 subjects, 129 had diabetes and 40 of the 232 subjects who were frequently tested for glucose levels had diabetes. The sensitivity and specificity of the HbA1c cut-off value of 6.5% in diagnosing diabetes were 55.0% and 80.9%, respectively. The highest correlation was observed between the glucose level at 90 minutes and AUC and HbA1c (r=0.971, P<0.01; r=0.464, P<0.01, respectively). Conclusion: An HbA1c cut-off value of 6.5% had low sensitivity and specificity in diagnosing diabetes. The plasma glucose level at 90 minutes in subjects had the best correlation with both AUC and HbA1c, indicating that using plasma glucose level at 90 minute is a better approach for diagnosing diabetes.

Anahtar Kelimeler

Diabetes Mellitus,HbA1c,glucose tolerance test

Kaynakça

1. Vivante A, Kohl S, Hwang DY, Dworschak GC, Hildebrandt F. Single-genecauses of congenital anomalies of the kidney and urinary tract (CAKUT) in humans. PediatrNephrol. 2014; 29: 695-704.
2. Ho J, Kreidberg JA. MicroRNAs in renal development. PediatrNephrol. 2013; 28: 219-25.
3. Dias T, Sairam S, Kumarasiri S. Ultrasound diagnosis of fetal renal abnormalities. Best Pract Res ClinObstetGynaecol. 2014; 28: 403-15.
4. van de Hoek G, Nicolaou N, Giles RH, Knoers NV, Renkema KY, Bongers EM. Functional models for congenital anomalies of the kidney and urinary tract. Nephron. 2015; 129: 62-7.
5. dos Santos Junior AC, de Miranda DM, Simões e Silva AC. Congenital anomalies of the kidney and urinary tract: an embryogenetic review. Birth Defects Res C Embryo Today. 2014; 102: 374-81.
6. Caruana G, Bertram JF. Congenital anomalies of the kidney and urinary tract genetics in mice and men. Nephrology (Carlton). 2015; 20: 309-11.
7. Baldassarre A, Felli C, Prantera G, Masotti A. Circulating microRNAs and Bioinformatics Tools to Discover Novel Diagnostic Biomarkers of Pediatric Diseases. Genes (Basel). 2017; 8: 234.
8. Makarova JA, Shkurnikov MU, Turchinovich AA, Tonevitsky AG, Grigoriev AI. Circulating microRNAs. Biochemistry (Mosc). 2015; 80: 1117-26.

9. Ivey KN, Srivastava D. microRNAs as Developmental Regulators. Cold Spring HarbPerspect Biol. 2015; 7: a008144.
10. Van der Hauwaert C, Savary G, Hennino MF, Pottier N, Glowacki F, Cauffiez C. MicroRNAs in kidney fibrosis. NephrolTher. 2015; 11: 474-82.
11. Kito N, Endo K, Ikesue M, Weng H, Iwai N. miRNA Profiles of Tubular Cells: Diagnosis of Kidney Injury. Biomed Res Int. 2015; 2015: 465479.
12. Akkina S, Becker BN. MicroRNAs in kidney function and disease. Transl Res. 2011; 157: 236-40.
13. Badal SS, Danesh FR. MicroRNAs and their applications in kidney diseases. PediatrNephrol. 2015; 30: 727-40.
14. Trionfini P, Benigni A, Remuzzi G. MicroRNAs in kidney physiology and disease. Nat Rev Nephrol. 2015; 11: 23-33.
15. Bhatt K, Kato M, Natarajan R. Mini-review: emerging roles of microRNAs in the pathophysiology of renal diseases. Am J Physiol Renal Physiol. 2016; 310: 109-18.
16. Ho J, Pandey P, Schatton T, et al. The pro-apoptotic protein Bim is a MicroRNA target in kidney progenitors. J Am SocNephrol. 2011; 22: 1053–63.
17. Nagalakshmi VK, Ren Q, Pugh MM, Valerius MT, McMahon AP, Yu J. Dicer regulates the development of nephrogenic and ureteric compartments in the mammalian kidney. Kidney Int. 2011; 79: 317-30.
18. Zhao H, Ma SX, Shang YQ, Zhang HQ, Su W. micro RNAs in chronic kidney disease. ClinChimActa. 2019; 491: 59-65.
19. Hartung EA, Guay-Woodford LM. Autosomal recessive polycystic kidney disease: a hepatorenal fibrocystic disorder with pleiotropic effects. Pediatrics. 2014; 134: 833-45.
20. Pandey P, Brors B, Srivastava PK, et al. Microarray-based approach identifies microRNAs and their target functional patterns in polycystic kidney disease. BMC Genomics. 2008; 9: 624.
21. Sun H, Li QW, Lv XY, et al. MicroRNA-17 post-transcriptionally regulates polycystic kidney disease-2 gene and promotes cell proliferation. MolBiol Rep. 2010; 37: 2951–8.
22. Lee SO, Masyuk T, Splinter P, et al. MicroRNA15a modulates expression of the cell-cycle regulator Cdc25A and affects hepatic cystogenesis in a rat model of polycystic kidney disease. J Clin Invest. 2008; 118: 3714–24.
23. Ho J, Pandey P, Schatton T, et al. The pro-apoptotic protein Bim is a MicroRNA target in kidney progenitors. J Am SocNephrol. 2011; 22: 1053–63.
24. Zhu S, Cao L, Zhu J, et al. Identification of maternal serum microRNAs as novel non-invasive biomarkers for prenatal detection of fetal congenital heart defects. ClinChimActa. 2013; 424: 66-72.
25. Song Y, Higgins H, Guo J, et al. Clinical significance of circulating microRNAs as markers in detecting and predicting congenital heart defects in children. J Transl Med. 2018; 2: 42.
26. Wojciechowska A, Braniewska A, Kozar-Kamińska K. MicroRNA in cardiovascular biology and disease. AdvClinExp Med. 2017; 26: 865-74.
27. Weber DG, Casjens S, Rozynek P, et al. Assessment of mRNA and microRNA Stabilization in Peripheral Human Blood for Multicenter Studies and Biobanks. Biomark Insights. 2010; 5: 95-102.
28. Abdul-Ghani MA, Abdul-Ghani T, Stern MP, et al. Two-step approach for the prediction of future type 2 diabetes risk. Diabetes Care. 2011; 34: 2108-12.
29. Kuang L, Huang Z, Hong Z, et al. Predictability of 1-h postload plasma glucose concentration: A 10-year retrospective cohort study. J Diabetes Investig. 2015; 6: 647-54.
30. Peddinti G, Bergman M, Tuomi T, et al. 1-Hour Post-OGTT Glucose Improves the Early Prediction of Type 2 Diabetes by Clinical and Metabolic Markers. J ClinEndocrinolMetab. 2019; 104: 1131-40.

Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Dilek Geneş Bu kişi benim
Türkiye

Zafer Pekkolay Bu kişi benim
Türkiye

Coşkun Beyaz Bu kişi benim
Türkiye

Faruk Kılınç Bu kişi benim
Türkiye

Alpaslan Kemal Tuzcu Bu kişi benim
Türkiye

Yayımlanma Tarihi

17 Mart 2020

Gönderilme Tarihi

25 Aralık 2019

Kabul Tarihi

27 Şubat 2020

Yayımlandığı Sayı

Yıl 2020 Cilt: 47 Sayı: 1

DOI

https://doi.org/10.5798/dicletip.706051

IZ

https://izlik.org/JA95HF33RM

Kaynak Göster

RIS / Bibtex

APA

Geneş, D., Pekkolay, Z., Beyaz, C., Kılınç, F., & Tuzcu, A. K. (2020). Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus? Dicle Medical Journal, 47(1), 97-104. https://doi.org/10.5798/dicletip.706051

AMA

1.Geneş D, Pekkolay Z, Beyaz C, Kılınç F, Tuzcu AK. Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus? diclemedj. 2020;47(1):97-104. doi:10.5798/dicletip.706051

Chicago

Geneş, Dilek, Zafer Pekkolay, Coşkun Beyaz, Faruk Kılınç, ve Alpaslan Kemal Tuzcu. 2020. “Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus?”. Dicle Medical Journal 47 (1): 97-104. https://doi.org/10.5798/dicletip.706051.

EndNote

Geneş D, Pekkolay Z, Beyaz C, Kılınç F, Tuzcu AK (01 Mart 2020) Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus? Dicle Medical Journal 47 1 97–104.

IEEE

[1]D. Geneş, Z. Pekkolay, C. Beyaz, F. Kılınç, ve A. K. Tuzcu, “Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus?”, diclemedj, c. 47, sy 1, ss. 97–104, Mar. 2020, doi: 10.5798/dicletip.706051.

ISNAD

Geneş, Dilek - Pekkolay, Zafer - Beyaz, Coşkun - Kılınç, Faruk - Tuzcu, Alpaslan Kemal. “Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus?”. Dicle Medical Journal 47/1 (01 Mart 2020): 97-104. https://doi.org/10.5798/dicletip.706051.

JAMA

1.Geneş D, Pekkolay Z, Beyaz C, Kılınç F, Tuzcu AK. Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus? diclemedj. 2020;47:97–104.

MLA

Geneş, Dilek, vd. “Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus?”. Dicle Medical Journal, c. 47, sy 1, Mart 2020, ss. 97-104, doi:10.5798/dicletip.706051.

Vancouver

1.Dilek Geneş, Zafer Pekkolay, Coşkun Beyaz, Faruk Kılınç, Alpaslan Kemal Tuzcu. Is HbA1c Misleading and 90-Minute Glucose Tolerance Test a Better Indicator in the Diagnosis of Diabetes Mellitus? diclemedj. 01 Mart 2020;47(1):97-104. doi:10.5798/dicletip.706051