최 은 영

단국대학교 의과대학 가정의학과

Background: This study aimed to evaluate hemoglobin A1c (HbA1c) level of 6.5% as a diagnostic criterion for diabetes mellitus (diabetes) compared with fasting glucose level of 126 mg/dl, and to compare the characteristics of the individuals diagnosed with diabetes by each of HbA1c and fasting glucose.
Methods: Data from the 1998 Korean National Health and Nutrition Examination Survey were used. Analyses were done for 4,875 adults (≥20 years) without a self-reported history of diabetes and anemia and had fasted for at least 8 hours and had the HbA1c level done.
Results: Of the 4,875 adults, 1.4% had HbA1c ≥6.5% and fasting glucose ≥126 mg/dl, 0.4% had HbA1c ≥6.5% and fasting glucose <126 mg/dl, and 5.6% had HbA1c <6.5% and fasting glucose ≥126 mg/dl. The pre- valence of diabetes was 7.0% by fasting glucose and 1.8% by HbA1c, which underestimated the prevalence of diabetes compared with fasting glucose. After adjusting for age, sex, smoking status, and BMI, individuals with concordant diabetes by both fasting glucose and HbA1c had higher fasting glucose, HbA1c, and waist circumference (P<0.05), and higher odds ratio for metabolic syndrome (OR=2.6, 95% confidence interval, 1.4-4.9, P<0.01) compared with those with discordant diabetes.
Conclusions: In Korean adults, HbA1c level of 6.5% as a diagnostic criterion was less sensitive in detecting newly diagnosed diabetes defined by fasting glucose. There was a significant difference in the odds ratio for metabolic syndrome between individuals with concordant and discordant diabetes defined by fasting glucose and HbA1c.
Korean J Health Promot 2010;10(4):162-168

Keywords: Diabetes mellitus, Hemoglobin A1c, Fasting glucose, Diagnosis, Metabolic syndrome