Diagnostic Sensitivity and Specificity of HbA1c assay in Screening of Diabetes Mellitus

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  • Yano Masao
    Clinical Laboratory, Mitsui Memorial Hospital
  • Yamakado Minoru
    Center for Multiphasic Health Testing and Services, Mitsui Memorial Hospital
  • Isogawa Akihiro
    Division of Diabetes and Metabolism, Department of Internal Medicine, Mitsui Memorial Hospital
  • Shiba Teruo
    Division of Diabetes and Metabolism, Department of Internal Medicine, Mitsui Memorial Hospital Toho University Ohashi Medical Center

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Other Title
  • ヘモグロビンA1c測定による糖尿病スクリーニングに関する検討
  • ヘモグロビン A1c ソクテイ ニ ヨル トウニョウビョウ スクリーニング ニ カンスル ケントウ

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Abstract

We assessed HbA1c sensitivity and specificity in detecting diabetes using the 75 g oral glucose tolerance test (OGTT) as the gold standard in 1485 subjects aged 22-89 years.<br> For HbA1c at the recommended ≥6.1% (JDS) cutoff, sensitivity was 56.6% and specificity 98.5%.<br> Based on receiver operating characteristic (ROC) analysis, the optimal HbA1c cutoff was 6.0% and FPG 106 mg/dl. Combining ≥6.0% HbA1c and ≥106 mg/dl FPG to detect diabetes, sensitivity increased markedly to 94% but specificity dropped to 92%. <br> Both HbA1c and FPG have low sensitivity of <40% for detecting poor (borderline) glucose tolerance.<br> The limited sensitivity of HbA1c alone may fail to identify a high proportion ->40%- of those with diabetes, so diabetes screening strategy should combine at least HbA1c and FPG.<br>

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