臺大公衛學院-公共衛生學系;臺大公衛學院-預防醫學研究所;臺大醫院;臺大醫院-內科部;臺大醫院雲林分院;臺大醫學院-臨床醫學研究所;HUNG-YUAN LIWen-Ya MaJung-Nan WeiMAO-SHIN LINSHYANG-RONG SHIHCHI-SHENG HUNGCyue-Huei HuaLEE-MING CHUANG2014-02-142018-07-112014-02-142018-07-112012-01-06http://ntur.lib.ntu.edu.tw//handle/246246/258862https://pubmed.ncbi.nlm.nih.gov/24843574/https://www.scopus.com/inward/record.uri?eid=2-s2.0-84861987231&doi=10.1111%2fj.2040-1124.2011.00181.x&partnerID=40&md5=cc0f693e147b9f7fc74bbd3829709041Aims/Introduction: To evaluate if hemoglobin A1c (A1C) can replace the use of the oral glucose tolerance test (OGTT) to diagnose diabetes in Chinese patients. Materials and Methods: Subjects without pre-existing diabetes were included in this community-based study. Each participant received a 75-g OGTT and A1C tests. Results: A total of 1362 subjects, 512 men and 850 women, aged 1888 years, were enrolled. The prevalence of diabetes was 7.4 and 7.3% by OGTT and by A1C = 6.5% criteria, respectively. The optimal A1C cut-off for diabetes defined by OGTT was 6.1%. The performance of A1C = 6.1% to find diabetes by OGTT was poor, with a kappa 0.50, sensitivity 80% and specificity 91%. Using current criteria of fasting plasma glucose (FPG) < 5.56 mmol/L to exclude and =7 mmol/L to diagnose diabetes (FPG criterion), the sensitivity, specificity and OGTT required were 77.2, 100 and 13.5%, respectively. Using A1C < 5.9% to exclude and =7.0% to diagnose diabetes (A1C criterion), the sensitivity, specificity and OGTT required were 89.1, 99.8 and 26.5%, respectively. However, using FPG < 5.56 mmol/L and A1C < 6.1% to exclude, and A1C = 7.0% to diagnose diabetes (A1C plus FPG criterion), the sensitivity, specificity and OGTT required were 85.2, 100 and 18.9%, respectively. Conclusions: To screen for diabetes, the A1C criterion is more sensitive than the FPG criterion, with more OGTT needed. The A1C plus FPG criterion reduced the number of OGTT needed with acceptable sensitivity. A1C can guide, but cannot replace, OGTT to diagnose diabetes. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00181.x, 2011)114 bytestext/htmlenDiagnosisHemoglobin A1cOral glucose tolerance test[SDGs]SDG3journal article10.1111/j.2040-1124.2011.00181.x24843574http://ntur.lib.ntu.edu.tw/bitstream/246246/258862/1/index.html