Glycated hemoglobin in the diagnosis of diabetes Mellitus in a semi-urban brazilian population

• Autor(a) principal: Moreira, Nayla Cristina do Vale
• Data de Publicação: 2019
• Outros Autores: Montenegro Jr., Renan M., Meyer, Haakon E., Bhowmik, Bishwajit, Mdala, Ibrahimu, Siddiquee, Tasnima, Fernandes, Virgínia Oliveira, Hussain, Akhtar
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/46567
• topic: Diabetes Mellitus; Hemoglobina A Glicada; Glycated Hemoglobin A; Diagnóstico; Diagnosis; Resistência à Insulina; Insulin Resistance

The study evaluated glycated hemoglobin (HbA1c) as a diagnostic tool for diabetes and pre-diabetes in the Brazilian population. Further, the homeostasis model assessment of insulin resistance (HOMA-IR) was also examined against HbA1c values to identify the most suitable cut-o points for HOMA-IR to predict the risk of diabetes. A cross-sectional study was conducted among 714 randomly selected subjects. HbA1c, fasting, and 2 h plasma glucose values were measured. Insulin resistance estimates were calculated with HOMA-IR. The receiver operating characteristic curve assessed HbA1c performance. The adjusted prevalence rate of diabetes mellitus was 14.7%, and pre-diabetes 14.2%. The optimal HbA1c cut-o value was 6.8% for the diagnosis of diabetes, and 6.0% for pre-diabetes. The area under the curve using HbA1c was 0.85 (95% CI: 0.80–0.90) for detecting diabetes and 0.61 (95% CI: 0.55–0.67) for pre-diabetes. The optimal HOMA-IR cut-o value was 2.06 for HbA1c at 6.8%. The HbA1c cut-o value of 6.8% may be suitable for diagnosing diabetes in the Brazilian population. Our results do not support the use of HbA1c to diagnose pre-diabetes. A HOMA-IR cut-o point of 2.06 was a sensitive marker to assess the risk of diabetes.