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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Editorial Board Member: Gillery, Philippe / Kazmierczak, Steven / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Whitfield, John B.

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Glycated hemoglobin vs. the oral glucose tolerance test for the exclusion of impaired glucose tolerance in high-risk individuals

Koldo Santos-Rey1 / Patricia Fernández-Riejos1 / Joaquín Mateo1 / Victor Sánchez-Margalet1 / Raimundo Goberna1

1Clinical Biochemistry Department, Virgen Macarena University Hospital, Sevilla, Spain

Corresponding author: Raimundo Goberna, Clinical Chemistry Laboratory, Virgen Macarena University Hospital, Avda. Dr. Fedriani s/n, Sevilla 41009, Spain Phone: +34 609 980304, Fax: +34 955 008105,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Issue 12, Pages 1719–1722, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.338, September 2010

Publication History

Received:
2009-12-02
Accepted:
2010-05-18
Published Online:
2010-09-17

Abstract

Background: The aim of this study was to compare the use of glycated hemoglobin (HbA1c) and the oral glucose tolerance test (OGTT) in the diagnosis of impaired glucose tolerance in high-risk individuals.

Methods: A total of 713 patients with at least two risk factors for the development of type 2 diabetes were enrolled in the study. Fasting glucose and HbA1c were measured in all individuals. Patients whose fasting glucose concentrations were below 7.0 mmol/L underwent an OGTT.

Results: From the 713 patients, 234 were euglycemic, 200 had impaired fasting glucose, 118 presented with impaired glucose tolerance and 161 met the diagnostic criteria for type 2 diabetes. OGTT was performed in a total of 596 patients (83.6%). Statistically significant differences were observed for HbA1c concentrations in all groups. Receiver operating characteristic curve analysis was performed to assess the capability of HbA1c to discriminate between normal glucose tolerance and impaired glucose tolerance. An HbA1c value of 36 mmol/mol (5.4%) gave an optimal sensitivity of 85% and a specificity of 73%, and a negative predictive value of 97% for identifying patients with impaired glucose tolerance.

Conclusions: HbA1c can be used to rule outpatients at high-risk of developing type 2 diabetes.

Clin Chem Lab Med 2010;48:1719–22.

Keywords: glycated hemoglobin; impaired glucose tolerance; oral glucose tolerance test

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