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Wen Y, Wang Q. Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population. World J Diabetes 2024; 15:1531-1536. [PMID: 39099814 PMCID: PMC11292326 DOI: 10.4239/wjd.v15.i7.1531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/25/2024] [Accepted: 05/23/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Glycated hemoglobin A1c (HbA1c) is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience. However, the effect of HbA1c on diabetic retinopathy (DR) in the Han and Korean populations in Jilin, China, remains inconclusive. AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese. METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province, China. Trained investigators employed a questionnaire-based survey, physical examination, laboratory tests, and fundus photography for the investigation. The best cut-off value for HbA1c was established via the receiver operating characteristic curve. The factors associated with HbA1c-associated risk factors were determined via linear regression. RESULTS The analysis included 887 eligible Chinese Han and Korean participants, 591 of whom were assigned randomly to the training set and 296 to the validation set. The prevalence of DR was 3.27% in the total population. HbA1c of 6.2% was the best cut-off value in the training set, while it was 5.9% in the validation set. In both Chinese Han and Korean populations, an HbA1c level of 6.2% was the best cut-off value. The optimal cut-off values of fasting blood glucose (FBG) ≥ 7 mmol/L and < 7 mmol/L were 8.1% and 6.2% respectively in Han populations, while those in Korean populations were 6.9% and 5.3%, respectively. Age, body mass index, and FBG were determined as the risk factors impacting HbA1c levels. CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR. An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.
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Affiliation(s)
- Yan Wen
- Department of Endocrinology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
| | - Qing Wang
- Department of Endocrinology, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
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Zhou Y, Wei J, Wang N, Chen Y, Fang C, Zhou M, Zhou X, Luo J, Wang X, Peng Q. The prevalence, incidence, and persistence of self-reported visual impairment among Chinese population with diabetes mellitus: evaluation from a nationally representative survey, 2015-2018. Front Public Health 2023; 11:978457. [PMID: 37397768 PMCID: PMC10308855 DOI: 10.3389/fpubh.2023.978457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 05/11/2023] [Indexed: 07/04/2023] Open
Abstract
Aims Our aim was to investigate the prevalence, incidence, and persistence of visual impairment (VI) and their correlates among the Chinese population with diabetes mellitus (DM) over 3 years. Materials and methods The China Health and Retirement Longitudinal Survey is the first nationally representative longitudinal survey of the Chinese population. A cross-sectional analysis of prevalent VI in 2015 consisted of 2,173 participants with DM. A longitudinal observation of incident and persistent VI consisted of 1,633 participants from 2015 to 2018. Risk factors of VI were identified via univariate and multivariate logistic regression analyses. Results Among our study population with DM, 11.8% reported VI in 2015, 4.5% had persistent VI from 2015 to 2018, and 8.9% developed VI in 2018. Factors identified to be correlated to VI (p < 0.05) were older age, being a woman, lower educational attainment, living in a rural area, application of DM medication and non-pharmacological treatment, receiving DM-related tests, use of spectacles, and poorer health status. Conclusion This most recent national data provides a baseline for future public health initiatives on VI among the Chinese population with DM. With multiple risk factors identified, these could provide concurrent targets for various public health strategies and interventions with the aim of reducing the burden of VI among the population with DM in China.
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Affiliation(s)
- Yifan Zhou
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Ophthalmology, Putuo People’s Hospital, Tongji University, Shanghai, China
| | - Jin Wei
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Ning Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Yisheng Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Cheng Fang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xinrong Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaodong Wang
- Shanghai Xin Qi Dian Rehabilitation Hospital, Shanghai, China
| | - Qing Peng
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
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Impact of Early Hemoglobin Levels on Neurodevelopment Outcomes of Two-Year-Olds in Very Preterm Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020209. [PMID: 36832338 PMCID: PMC9955539 DOI: 10.3390/children10020209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate, in very preterm infants, the hemoglobin (Hb) levels during the first 24 h and the neurodevelopment outcomes at 24 months of corrected age. DESIGN, SETTING, AND PATIENTS We conducted a secondary analysis of the French national prospective and population-based cohort EPIPAGE-2. The eligible study participants were live-born singletons who were born before 32 weeks of gestational age, with early Hb levels who were admitted to the neonatal intensive care unit. MAIN OUTCOME MEASURES The early Hb levels for an outcome survival at 24 months of corrected age without neurodevelopmental impairment were measured. The secondary outcomes were survival at discharge and without severe neonatal morbidity. RESULTS Of the 2158 singletons of <32 weeks with mean early Hb levels of 15.4 (±2.4) g/dL, 1490 of the infants (69%) had a follow-up at two years of age. An early Hb of 15.2 g/dL is the minimum receiving operating characteristic curve at the 24 months risk-free level, but the area under the curve at 0.54 (close to 50%) indicates that this rate was not informative. In logistic regression, no association was found between early Hb levels and outcomes at two years of age (aOR 0.966; 95% CI [0.775-1.204]; p = 0.758) but rather there was a correlation found with severe morbidity (aOR 1.322; 95% CI [1.003-1.743]; p = 0.048). A risk stratification tree showed that male newborns of >26 weeks with Hb of <15.5 g/dL (n = 703) were associated with a poor outcome at 24 months (OR 1.9; CI: [1.5-2.4] p < 0.01). CONCLUSIONS Early low Hb levels are associated with major neonatal morbidities in VP singletons, but not with neurodevelopment outcomes at two years of age, except in male infants of >26 Weeks GA.
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Gong YY, Peng HY. Correlation analysis of epicardial adipose tissue thickness, C-reactive protein, interleukin-6, visfatin, juxtaposed with another zinc finger protein 1, and type 2 diabetic macroangiopathy. Lipids Health Dis 2021; 20:25. [PMID: 33722242 PMCID: PMC7962295 DOI: 10.1186/s12944-021-01451-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/02/2021] [Indexed: 12/21/2022] Open
Abstract
Background To investigate the correlation between the thickness of epicardial adipose tissue (EAT), C-reactive protein (CRP), interleukin (IL) -6, visfatin, juxtaposed with another zinc finger protein 1 (JAZF1) and type 2 diabetic mellitus (T2DM) macroangiopathy. Methods The study enrolled 82 patients with T2DM with macroangiopathy (the Complication Group), and 85 patients with T2DM (the Diabetes Group) who were admitted to Shandong Provincial Third Hospital from February 2018 to February 2020. In addition, 90 healthy people who underwent physical examination at the same hospital during the same period were enrolled (the Healthy Control Group). Age, gender, height, weight, waist circumference (WC), hip circumference (HC), diabetic course and therapeutic drugs, waist hip ratio (WHR), and body mass index (BMI) were recorded and calculated. Results The baseline characteristics of the three groups were comparable, and the diabetic course of the Complication Group and the Diabetes Group was not significantly different (P > 0.05). The WHR of the Complication Group was higher than that of the Diabetes Group and the Healthy Control Group, with statistical significance (P < 0.05). The FPG, 2hPG, HbA1C, CRP, IL-6, Visfatin, JAZF1, HOMA-IR, EAT thickness, and baPWV of the Complication Group were all higher than those of the Diabetes Group and the Healthy Control Group (P < 0.05, respectively). The JAZF1 and FIns of the Complication Group and Diabetes Group were lower than those of the Healthy Control Group, and JAZF1 of the Complication Group was lower than the Diabetes Group with statistical significance (P<0.05, respectively). Pearson correlation analysis showed that the EAT thickness was positively correlated with CRP, IL-6, visfatin, and JAZF1 (r = 0.387, 0.451, 0.283, 0.301, respectively, all P<0.001). Pearson correlation analysis showed that baPWV was positively correlated with EAT thickness, CRP, IL-6, visfatin, and JAZF1 (r = 0.293, 0.382, 0.473, 0.286, respectively, all P < 0.001). Multivariate stepwise regression analysis showed that FPG, 2hPG, HbA1C, CRP, IL-6, visfatin, JAZF1, and EAT thickness were independent risk factors that affected T2DM macroangiopathy. Conclusions Clinical monitoring and treatment of T2DM macroangiopathy can use CRP, IL-6, Visfatin, JAZF1, and EAT thickness as new targets to delay the progression of the disease. Further research on the relationship between the above factors and the pathogenesis of T2DM macroangiopathy may be helpful provide new treatment strategies.
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Affiliation(s)
- Yuan-Yuan Gong
- Department of Endocrinology, Qingdao West Coast New Area Central Hospital, Qingdao, China
| | - Hai-Ying Peng
- Department of Special Examination, Shandong Provincial Third Hospital, Shandong University, No 11 Wuying Mountain Middle Road, Tianqiao Distrct, Jinan, 250031, China.
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Chao G, Zhu Y, Chen L. Role and Risk Factors of Glycosylated Hemoglobin Levels in Early Disease Screening. J Diabetes Res 2021; 2021:6626587. [PMID: 33880380 PMCID: PMC8049785 DOI: 10.1155/2021/6626587] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To clarify the correlation among glycosylated hemoglobin (HbA1c), gender, age, fatty liver, and biochemical indicators through the analysis of big database, and to further investigate the risk factors affecting HbA1c, so as to lay a foundation for the study of HbA1c-related diseases and disease management. METHODS People who have been examined in Health Promotion Center from July 2018 to June 2019 were selected as the research objects. All data were analyzed using the Windows R software (version 3.5.1). Detailed medical history inquiry, laboratory examination, and B-ultrasound examination were carried out for the selected sample population. We determined the sample population according to the inclusion and exclusion criteria and, then, further grouped and analyzed the data. T-test or Mann-Whitney U test was used for continuous variable comparison, and chi-square test was used to compare categorical variables. Logistic regression analysis was used to analyze the risk factors of HbA1c. RESULTS A total of 23,933 subjects were included in this study. The HbA1c level of men was significantly higher than that of women, the HbA1c level of the group with diabetes was higher than that of the group with no diabetes, and the HbA1c level of the group with fatty liver was higher than that of the group with no fatty liver. In the group with no diabetes, the HbA1c level increased with weight gain. Age, gender (male), fatty liver, waist circumference, systolic blood pressure (SBP), triglyceride (TG), blood urea nitrogen (BUN), free thyroxine (FT4), and red blood cell (RBC) were the risk factors for elevated HbA1c level, while high-density lipoprotein cholesterol (HDL-C), uric acid (UA), creatinine (Cr), free triiodothyronine (FT3), and hemoglobin were protective factors. CONCLUSION Blood glucose, age, weight, gender, fatty liver, blood lipids, and UA are related to the increase of HbA1c level. HbA1c is related to many metabolic indexes and may be used as a marker for early detection of chronic diseases.
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Affiliation(s)
- Guanqun Chao
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, China
| | - Yue Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, China
| | - Liying Chen
- Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, China
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Han WP, Huang L, Li YY, Han YY, Li D, An BQ, Huang SW. Reference intervals for HbA 2 and HbF and cut-off value of HbA 2 for β-thalassemia carrier screening in a Guizhou population of reproductive age. Clin Biochem 2018; 65:24-28. [PMID: 30503531 DOI: 10.1016/j.clinbiochem.2018.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 11/02/2018] [Accepted: 11/17/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to establish the reference intervals for HbA2 and HbF in a Guizhou population of reproductive age, and to determine the cut-off value of HbA2 for β-thalassemia carrier screening. METHODS Hemoglobin analysis was performed on 832 individuals without hypochromic microcytic anemia to calculate the reference intervals for HbA2 and HbF. Three hundred and ninety one β-thalassemia carriers and non β-thalassemia individuals were analyzed for their HbA2 levels followed by detecting β-globin gene mutations, then cut-off value of HbA2 for β-thalassemia carrier screening was determined using ROC curve analysis. RESULTS The reference interval for HbA2 in overall normal individuals was 2.3%-3.1%, and reference intervals for HbF in normal males and females (including normal females and pregnant women) were 0-0.5% and 0-1.0% respectively. The cut-off values of HbA2 for β-thalassemia carrier screening in males, non-pregnant women, pregnant women and the overall set were 4.40%, 3.75%, 3.70% and 3.95% respectively. CONCLUSION Gender and pregnancy status had no obvious influence on reference interval for HbA2. The HbF level was higher in females than in males, but pregnancy status had no obvious influence on HbF level. Cut-off value of HbA2 for β-thalassemia carrier screening was obviously affected by gender but not by pregnancy status.
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Affiliation(s)
- Wen-Ping Han
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China; Nanjing Red Cross Blood Center, Nanjing 210003, Jiangsu, PR China
| | - Ling Huang
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China
| | - Yuan-Yuan Li
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China
| | - Yuan-Yuan Han
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China; Medical college, Guizhou University, South Jiaxiu Road, Guiyang 550025, Guizhou, PR China
| | - Di Li
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China
| | - Bang-Quan An
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China.
| | - Sheng-Wen Huang
- Department of Laboratory, Guizhou Provincial People's Hospital, No.83 East Zhongshan Road, Guiyang 550002, Guizhou, PR China; Medical college, Guizhou University, South Jiaxiu Road, Guiyang 550025, Guizhou, PR China.
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Kaur J, Jiang C, Liu G. Different strategies for detection of HbA1c emphasizing on biosensors and point-of-care analyzers. Biosens Bioelectron 2018; 123:85-100. [PMID: 29903690 DOI: 10.1016/j.bios.2018.06.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/23/2018] [Accepted: 06/06/2018] [Indexed: 12/21/2022]
Abstract
Measurement of glycosylated hemoglobin (HbA1c) is a gold standard procedure for assessing long term glycemic control in individuals with diabetes mellitus as it gives the stable and reliable value of blood glucose levels for a period of 90-120 days. HbA1c is formed by the non-enzymatic glycation of terminal valine of hemoglobin. The analysis of HbA1c tends to be complicated because there are more than 300 different assay methods for measuring HbA1c which leads to variations in reported values from same samples. Therefore, standardization of detection methods is recommended. The review outlines the current research activities on developing assays including biosensors for the detection of HbA1c. The pros and cons of different techniques for measuring HbA1c are outlined. The performance of current point-of-care HbA1c analyzers available on the market are also compared and discussed. The future perspectives for HbA1c detection and diabetes management are proposed.
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Affiliation(s)
- Jagjit Kaur
- Graduate School of Biomedical Engineering, ARC Centre of Excellence in Nanoscale Biophotonics (CNBP), Faculty of Engineering, The University of New South Wales, Sydney 2052, Australia; Australian Centre for NanoMedicine, The University of New South Wales, Sydney 2052, Australia
| | - Cheng Jiang
- Nuffield Department of Clinical Neurosciences, Department of Chemistry, University of Oxford, Oxford OX1 2JD, United Kingdom
| | - Guozhen Liu
- Graduate School of Biomedical Engineering, ARC Centre of Excellence in Nanoscale Biophotonics (CNBP), Faculty of Engineering, The University of New South Wales, Sydney 2052, Australia; Australian Centre for NanoMedicine, The University of New South Wales, Sydney 2052, Australia; International Joint Research Center for Intelligent Biosensor Technology and Health, Central China Normal University, Wuhan 430079, PR China.
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