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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

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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1437-4331
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Volume 53, Issue 9

Issues

Comparing HbA1c, fasting and 2-h plasma glucose for screening for abnormal glucose regulation in patients undergoing coronary angiography

Jun-Sing Wang
  • Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
  • Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Other articles by this author:
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/ I-Te Lee
  • Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
  • Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Department of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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/ Wen-Jane Lee / Shih-Yi Lin
  • Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
  • Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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/ Chia-Po Fu
  • Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
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/ Wen-Lieng Lee
  • Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
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/ Kae-Woei Liang
  • Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Department of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  • Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
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/ Wayne Huey-Herng Sheu
  • Corresponding author
  • Division of Endocrinology and Metabolism, Taichung Veterans General Hospital, Taichung, Taiwan
  • Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  • Institute of Medical Technology, College of Life Science, National Chung-Hsing University, Taichung, Taiwan
  • Email
  • Other articles by this author:
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Published Online: 2014-11-18 | DOI: https://doi.org/10.1515/cclm-2014-0860

Abstract

Background: We aimed to investigate the prevalence of undiagnosed abnormal glucose regulation (AGR, including diabetes and prediabetes) in patients undergoing coronary angiography (CAG) by using both glycated hemoglobin (HbA1c) and oral glucose tolerance test (OGTT) to screen, and to compare the performance of fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), and HbA1c for screening for AGR.

Methods: Eligible patients were adults without known diabetes who were admitted for CAG. Patients’ glucose regulation status was defined by conducting HbA1c and OGTT 2–4 weeks after hospital discharge. The performance of FPG, 2hPG, and HbA1c for detecting AGR was evaluated using receiver operating characteristic (ROC) analysis.

Results: A total of 689 subjects were included. According to OGTT, the prevalence rates of diabetes and prediabetes were 19.9% and 41.7%, respectively. The corresponding values were 28.0% and 60.4%, respectively, when HbA1c was adopted as a diagnostic criterion in addition to OGTT. For detecting diabetes, the area under the ROC curve (AUC) was higher for HbA1c than for FPG (0.87 vs. 0.80, p=0.005), but was not significantly different from that for 2hPG (0.87 vs. 0.88, p=0.58). For detecting AGR, the AUC was higher for HbA1c than for either FPG (0.94 vs. 0.74, p<0.001) or 2hPG (0.94 vs. 0.83, p<0.001).

Conclusions: Using HbA1c and OGTT to screen, we reported an extremely high prevalence of previously undiagnosed AGR (28.0% diabetes and 60.4% prediabetes) in patients admitted for CAG. HbA1c may be adopted as an alternative to OGTT for screening for AGR in patients undergoing CAG.

This article offers supplementary material which is provided at the end of the article.

Keywords: coronary artery disease; diabetes; glycated hemoglobin; oral glucose tolerance test

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About the article

Corresponding author: Wayne Huey-Herng Sheu, Taichung Veterans General Hospital, #1650, Sec. 4, Taiwan Boulevard, Taichung 407, Taiwan, Phone: +886 4 23592525 ext. 2002, Fax: +886 4 23593662, E-mail:


Received: 2014-08-27

Accepted: 2014-10-22

Published Online: 2014-11-18

Published in Print: 2015-08-01


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 53, Issue 9, Pages 1441–1449, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2014-0860.

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