한국인에서 미국 당뇨병 학회의 당뇨병 진단 기준인 당화혈색소의 적합성 = Acceptability of HbA1c values as a diagnostic tool for diabetes mellitus in Korea

다국어 초록 (Multilingual Abstract)

Background/Aims: In 2010, the American Diabetes Association (ADA) adopted glycated hemoglobin (HbA1c) as a new diagnostic criterion for diabetes mellitus. However, HbA1c values may differ among races. We determined whether this criterion could be applied to Korean diabetics. Methods: Between January 2000 and January 2010, 1,862 patients among Konyang University Hospital visitors in which the 75 g oral glucose tolerance test (OGTT) and HbA1c were checked at the same time were enrolled. We excluded patients with acute disease, an Hb ≤ 10 g/dL, a Cr ≥ 2 mg/dL, those prescribed oral hypoglycemic agents or insulin, and those who were pregnant. Results: After applying the exclusion criteria, 1,474 Korean patients were enrolled. All had common features of Korean diabetics for body mass index and homeostatic model assessment of insulin resistance values. Using the 0 and 120 minute glucose levels of the OGTT from the receiver operating characteristic curve, the HbA1c cutoff value was 6.25%. The cutoff value to diagnose diabetes with the presence of diabetic retinopathy was 6.75%. Conclusions: Our study showed a difference between the HbA1c values for diagnosing diabetes and the new diagnostic criterion from the ADA. Considering that the HbA1c characteristics may be influenced by race or culture, larger studies on diabetes complications are needed to identify the appropriate HbA1c value for Korean diabetics. (Korean J Med 79:673-680, 2010)

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