Poor accuracy of HbA1c for the diagnosis of prediabetes in overweight and obese Bangladeshi adults.

Haq, Tahniyah; Fariduddin, Md.; Hasanat, Md Abul; Aurpa, Nishat Nayla; Bhuiyan, Md. Sohel Rana; Tanni, Afia Zainab

Background/Purpose: The aim of the study was to assess the effect of obesity on the diagnostic accuracy of HbA1c. Methods: This retrospective cross sectional study was conducted in 108 overweight/obese and 40 normal weight Bangladeshi adults. Those satisfying the exclusion and inclusion criteria were included. Diabetes and pre-diabetes were diagnosed by oral glucose tolerance test (OGTT) and HbA1c using the 2006 World Health Organization (WHO) diagnostic criteria. HbA1c was estimated by capillary electrophoresis method. Results: 108 overweight and obese (mean body mass index (BMI) 36.33 ± 8.86 kg/m2, mean age 29.12 ± 9.28 years) and 40 normal weight (mean BMI 20.35 ± 1.68 kg/m2, mean age 28.13 ± 6.22 years) adults were included in the study. Significantly greater number of patients were diagnosed with prediabetes using HbA1c criteria than OGTT criteria (39.68% vs 19.05%, p = 0.005) in overweight and obese group. The concordance between OGTT and HbA1c for the diagnosis of prediabetes was low in overweight and obese adults [Ƙ with 95%CI = 0.031(-0.194 to 0.256), n = 52]. The specificity and discrimination of HbA1c for the diagnosis of prediabetes were low in overweight and obese compared to normal weight group (52.3% vs 93.9%; 0.64 vs 0.89, p = 0.056, 95% CI = -0.01 to 0.51, respectively). The specificity of HbA1c for the diagnosis of prediabetes in adults with BMI ≥ 23 kg/m2 increased to 90% at a cut-off of 6.15%. Conclusion: HbA1c was not accurate in the diagnosis of prediabetes in adults with BMI ≥ 23 kg/m2. A higher cut-off value for HbA1c should be used for the diagnosis of prediabetes, but not diabetes.

BANGLADESH; DIAGNOSIS of diabetes; PREDIABETIC state; GLYCOSYLATED hemoglobin; ACADEMIC medical centers; BODY mass index; GLUCOSE tolerance tests; BODY weight; DIAGNOSTIC errors; RETROSPECTIVE studies; DESCRIPTIVE statistics; LDL cholesterol; LONGITUDINAL method; STATURE; WAIST circumference; MEDICAL records; ACQUISITION of data; COMPARATIVE studies; CONFIDENCE intervals; BLOOD pressure; TRIGLYCERIDES; OBESITY; SENSITIVITY & specificity (Statistics); DIABETES

International Journal of Diabetes in Developing Countries, 2024, Vol 44, Issue 4, p680

0973-3930

Academic Journal

10.1007/s13410-023-01302-4