Mirzazada V. A., Ismayilova S. M., Sultanova S. S.

PREDIABETIC CUT-OFF POINT FOR GLYCATED HEMOGLOBIN

---

Show/Download

About the author:

Mirzazada V. A., Ismayilova S. M., Sultanova S. S.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Prediabetes is significant health condition in which blood glucose levels are higher, but not enough yet to be diagnosed as diabetes. The article provides a detailed examination of a research study investigating the possibility of using glycated hemoglobin (HbA1C) as a main diagnostic criterion for definition of normal carbohydrate metabolism (NCM)/prediabetes (PD) cut-off point. The study assessed 134 individuals (32 men and 102 women) aged 20 years and older using anthropometric measurements and laboratory biomarkers. A 75-gram oral glucose tolerance test (OGTT) was conducted. Correlation analysis was performed to examine the interrelationships between indicators and regression analyses were used to estimate the “cut-off” point for HbA1c. The Youden index was applied to identify the optimal “cut-off” point of HbA1c for diagnosis impaired carbohydrate metabolism (ICM). The values of FG, GL120 and HbA1c were compared by area under the receiver operating characteristic curves (AUC). The correlation between HbA1c and FG (r=+0.63 [95% CI +0.516; +0.722; p<0.0001]), as well as between HbA1c and GL120 (r=+0.73 [95% CI +0.640; +0.800; p<0.0001]), served as the fundamental basis of this study. Through the application of multiple linear regression analyses, formulas were derived to establish the “cut-off” values. The Youden Index for the “cut-off” of 38 mmol/mol was 66.0%. The Specificity and Positive Predictive Value for this threshold were both 100%. AUC was 0.80 for FG, 0.60 for GL120, and 0.81 for HbA1c. An HbA1c level of ≥39 mmol/mol was identified as the optimal “cut-off” for defining ICM.

Tags:

Bibliography:

1. Hossain J, Mamun A, Islam R. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep. 2024;7(3):e2004. DOI: 10.1002/hsr2.2004.
2. International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels: International Diabetes Federation; 2021. 135 p.
3. Xuedong A, Yuehong Z, Wenjie S. Early effective intervention can significantly reduce all-cause mortality in prediabetic patients: a systematic review and meta-analysis based on high-quality clinical studies. Front Endocrinol. 2024;15:1294819.
4. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379:2279-2290.
5. American Diabetes Association Professional Practice Commitee. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes 2025. Diabetes Care. 2025;48(1):S27-S49.
6. World Health Organization. Classification of Diabetes Mellitus. Geneva: WHO; 2019. Available from: https://www.who.int/health-topics/ diabetes.
7. Nathan DM, DCCT/EDIC Research Group. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview. Diabetes Care. 2014;37(1):9-16. DOI: 10.2337/dc13-2112.
8. International Expert Committee. International expert committee report on the role of the A1C assay in the diagnosis of diabetes 2009. Diabetes Care 2009;32:1327-1334.
9. The confidence interval of rho. Available from: http://vassarstats.net/rho.html.
10. Multiple linear regression calculator. Available from: https://stats.blue/ Stats_Suite/multiple_linear_regression _calculator.html.
11. Chatzimichail T, Hatjimihail AT. A Software Tool for Exploring the Relation Between Diagnostic Accuracy and Measurement Uncertainty Diagnostics. Diagnostics. 2020;10:610.
12. Çorbacıoğlu Ş, Aksel G. Receiver operating characteristic curve analysis in diagnostic accuracy studies: A guide to interpreting the area under the curve value. Turk J Emerg Med. 2023;23(4):195-198. DOI: 10.4103/tjem.tjem_182_23.
13. Ismayilova S, Sultanova S, Huseynova A, Mirzazade V. Definition of Normal Prediabetes Cutoff Point for Fasting Glycaemia on the Basis of Glucose Tolerance Test and HbA1c Interrelationships. J Endocr Soc. 2021;5:320.
14. Diabetes Canada Clinical Practice Guidelines Expert Committee, Punthakee Z, Goldenberg R, Katz P. Definition Classification and Diagnosis of Diabetes Prediabetes and Metabolic Syndrome. Can J Diabetes. 2018;42:10-15.
15. Bell K, Shaw JE, Maple-Brown L, Ferris W, Gray S, Murfet G, et al. A position Statement on Screening and Management of Prediabetes in Adults in Primary Care in Australia. Diabetes Res Clin Pract. 2020;164:108188.

Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 1, 176, 238-243 pages, index UDC 616.43

DOI:

10.29254/2077-4214-2025-1-176-238-243