Performance of glycated haemoglobin (HbA1c) as a screening test for diabetes and impaired glucose tolerance (IGT) in a high risk population: the brazilian Xavante indians

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2014
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Elsevier
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Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.
Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.
Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.
Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.
Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.
Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina. Divisão de Endocrinologia. São Paulo, SP, Brasil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina. Divisão de Endocrinologia. São Paulo, SP, Brasil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina. Divisão de Endocrinologia. São Paulo, SP, Brasil.
Universidade Federal de São Paulo. Escola Paulista de Medicina. Departamento de Medicina. Divisão de Endocrinologia. São Paulo, SP, Brasil.
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Abstract
Abstract
Aims: To examine the properties of HbA1c to detect diabetes and IGT in adult Brazilian Xavante Indians, a high risk population for diabetes. Methods: The survey was carried out between October 2010 and January 2012 and based on a 75 g oral glucose tolerance test (OGTT). Basal and 2 h capillary glycaemia were measured by HemoCue Glucose 201+; HbA1c using an automated high-performance liquid chromatography analyzer (Tosoh G7). Results: 630 individuals aged ≥ 20 years were examined and 80 had a previous diagnosis of diabetes. Sensitivity, specificity and accuracy for HbA1c ≥ 6.5% (≥48 mmol/mol) were 71.3%, 90.5% and 87.2%. The areas under the ROC curve (AUC) was 0.88 (95%CI: 0.83–0.93). To identify IGT, HbA1c values between 5.7% and 6.4% (39–47 mmol/mol) presented sensitivity, specificity and accuracy of 87.2%, 24.7% and 51.4%, with an AUC of 0.62 (95%CI: 0.57–0.67). Conclusions: The ADA/WHO proposed cut-off of 6.5% (48 mmol/mol) for HbA1c was adequate to detect diabetes among the Xavante. However, the performance of the ADA proposed cutoff points for pre-diabetes, when used to detect IGT was inadequate and should not be recommended.
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Keywords in Portuguese
Doenças e Agravos Não Transmissíveis, Mato Grosso, Região Amazônica, Região Centro-Oeste, Xavante, Doenças Crônicas não Transmissíveis, Intolerância à Glicose
Keywords
Diabetes mellitus, Impaired glucose tolerance, HbA1c, Brazilian indians
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Brasil, Índios Sul-Americanos, Saúde de Populações Indígenas, Ecossistema Amazônico, Epidemiologia, Diabetes Mellitus, Estudos Epidemiológicos, Doenças não Transmissíveis
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FRANCO, Laercio Joel et al. Performance of glycated haemoglobin (HbA1c) as a screening test for diabetes and impaired glucose tolerance (IGT) in a high risk population: the brazilian Xavante indians. Diabetes Research and Clinical Practice, v. 106, n. 2, p. 337-342, 14 Sept. 2014.
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0168-8227
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10.1016/j.diabres.2014.08.027
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