Please use this identifier to cite or link to this item: https://doi.org/10.1210/jc.2014-2498
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dc.titleDiagnosis of Diabetes Mellitus Using HbA1c in Asians: Relationship Between HbA1c and Retinopathy in a Multiethnic Asian Population
dc.contributor.authorSabanayagam, Charumathi
dc.contributor.authorKhoo, Eric YH
dc.contributor.authorLye, Weng Kit
dc.contributor.authorIkram, M Kamran
dc.contributor.authorLamoureux, Ecosse L
dc.contributor.authorCheng, Ching Yu
dc.contributor.authorTan, Maudrene LS
dc.contributor.authorSalim, Agus
dc.contributor.authorLee, Jeannette
dc.contributor.authorLim, Su-Chi
dc.contributor.authorTavintharan, Subramaniam
dc.contributor.authorThai, Ah-Chuan
dc.contributor.authorHeng, Derrick
dc.contributor.authorMa, Stefan
dc.contributor.authorTai, E Shyong
dc.contributor.authorWong, Tien Y
dc.date.accessioned2020-06-05T08:17:45Z
dc.date.available2020-06-05T08:17:45Z
dc.date.issued2015-02-01
dc.identifier.citationSabanayagam, Charumathi, Khoo, Eric YH, Lye, Weng Kit, Ikram, M Kamran, Lamoureux, Ecosse L, Cheng, Ching Yu, Tan, Maudrene LS, Salim, Agus, Lee, Jeannette, Lim, Su-Chi, Tavintharan, Subramaniam, Thai, Ah-Chuan, Heng, Derrick, Ma, Stefan, Tai, E Shyong, Wong, Tien Y (2015-02-01). Diagnosis of Diabetes Mellitus Using HbA1c in Asians: Relationship Between HbA1c and Retinopathy in a Multiethnic Asian Population. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 100 (2) : 689-696. ScholarBank@NUS Repository. https://doi.org/10.1210/jc.2014-2498
dc.identifier.issn0021-972X
dc.identifier.issn1945-7197
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/169460
dc.description.abstractCopyright © 2015 by the Endocrine Society. Context: Hemoglobin A1c (HbA1c) ≥6.5% (47.5 mmol/mol) has recently been included as a criterion for the diagnosis of diabetes mellitus. It is unclear whether this criterion is appropriate in Asians. Objective: To examine the relationship between HbA1c and diabetes-specific moderate retinopathy in Asian ethnic groups. Design, Setting, and Participants: Four independent population-based cross-sectional studies (2004-2011) in Singapore representing the three major Asian ethnic groups (n = 13 170 adults aged ≥25 y: Chinese, 5834; Malays, 3596; and Indians, 3740). Main Outcome: Moderate retinopathy was assessed from digital retinal photographs and defined as a level >43 using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve for detecting moderate retinopathy were compared across ethnic groups at different HbA1c cut-points. Results: HbA1c levels were higher in Indians and Malays compared to Chinese (P < .001). The prevalence of moderate retinopathy below HbA1c <6.5% was <1% in all ethnic groups. At HbA1c ≥6.5%, the sensitivity for detecting moderate retinopathy was lower in Chinese subjects compared to Indians and Malays (75.8 vs 86.0 and 85.3%), but specificity (89.7 vs 71.9 and 76.3%) was higher; however, positive predictive value and negative predictive value were similar among Chinese, Indians, and Malays (10.5, 12.3,12.4%; and 99.6, 99.1, 99.2%, respectively). The AUCs were similar across all three ethnic groups (0.861, 0.851, and 0.853). Conclusions: Our study supports the use of HbA1c for diagnosing diabetes in Asians. Despite some interethnic variation in the relationship of HbA1c and retinopathy, a cut-point of 6.5% performs reasonably well in the three major Asian ethnic groups.
dc.language.isoen
dc.publisherENDOCRINE SOC
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectEndocrinology & Metabolism
dc.subjectGLYCATED HEMOGLOBIN
dc.subjectETHNIC-DIFFERENCES
dc.subjectFASTING GLUCOSE
dc.subjectHBA(1C) LEVELS
dc.subjectBLOOD-GLUCOSE
dc.subjectEYE DISEASES
dc.subjectA1C
dc.subjectA(1C)
dc.subjectASSOCIATION
dc.subjectMETHODOLOGY
dc.typeArticle
dc.date.updated2020-06-03T14:10:16Z
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.contributor.departmentDEPT OF MEDICINE
dc.contributor.departmentSAW SWEE HOCK SCHOOL OF PUBLIC HEALTH
dc.description.doi10.1210/jc.2014-2498
dc.description.sourcetitleJOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
dc.description.volume100
dc.description.issue2
dc.description.page689-696
dc.published.statePublished
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