Zengmei Sun, Suyuan Wang, Hua He, Chenghui Zhang, Mingxia Li, Yan Ye, Huiqin Zhang, Xuanyu Yao, Shuyao Sun, Yuanze Du, Yang Zhong, Yunhong Wu
{"title":"高海拔居住史对检测葡萄糖代谢异常的最佳 HbA1c 临界值的影响","authors":"Zengmei Sun, Suyuan Wang, Hua He, Chenghui Zhang, Mingxia Li, Yan Ye, Huiqin Zhang, Xuanyu Yao, Shuyao Sun, Yuanze Du, Yang Zhong, Yunhong Wu","doi":"10.1089/ham.2024.0030","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Aims:</i></b> To explore the influence of recent high-altitude residential history on the optimal cutoff of glycosylated hemoglobin (HbA1c) for detecting abnormal glucose metabolism. <b><i>Methods:</i></b> The study included 505 self-reported healthy Han participants of age 18-65 years, recruited in Chengdu and categorized based on recent (within 3 months) high-altitude (>2,500 m) residential history. The 1999 WHO criteria was used as the gold standard for defining prediabetes and diabetes. HbA1c test performance was assessed using receiver operating characteristic curve, with the optimal cutoff determined by Maximum Youden index. Propensity score matching with 0.02 calipers and nearest neighbor method was used to balance confounding factors between groups. <b><i>Results:</i></b> Of the participants, 238 (47.13%) were populations with recent high-altitude residential history (HA group), and 267 (52.87%) were low-altitude dwellers (LA group). The HA group had slightly higher HbA1c levels (<i>p</i> > 0.05) and higher erythrocyte and hemoglobin levels (<i>p</i> < 0.05), compared to the LA group. Weak correlations between prediabetes and HbA1c levels were observed in the HA group (<i>r</i><sub>s</sub> = 0.21, <i>p</i> < 0.05) and the LA group (<i>r</i><sub>s</sub> = 0.07, <i>p</i> = 0.25). The optimal cutoff for the detection of diabetes was 6.5% (area under the curve [AUC] 0.94) in the HA group and 5.9% (AUC 0.97) in the LA group, which remained unchanged after adjustment for confounders. <b><i>Conclusions:</i></b> The optimal cutoff of HbA1c for the detection of diabetes in populations with recent history of living at high altitude was higher than that in general populations living at low altitude, and the diagnostic value of HbA1c for prediabetes was also inadequate.</p>","PeriodicalId":12975,"journal":{"name":"High altitude medicine & biology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of High-Altitude Residential History on Optimal HbA1c Cutoff for Detecting Abnormal Glucose Metabolism.\",\"authors\":\"Zengmei Sun, Suyuan Wang, Hua He, Chenghui Zhang, Mingxia Li, Yan Ye, Huiqin Zhang, Xuanyu Yao, Shuyao Sun, Yuanze Du, Yang Zhong, Yunhong Wu\",\"doi\":\"10.1089/ham.2024.0030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Aims:</i></b> To explore the influence of recent high-altitude residential history on the optimal cutoff of glycosylated hemoglobin (HbA1c) for detecting abnormal glucose metabolism. <b><i>Methods:</i></b> The study included 505 self-reported healthy Han participants of age 18-65 years, recruited in Chengdu and categorized based on recent (within 3 months) high-altitude (>2,500 m) residential history. The 1999 WHO criteria was used as the gold standard for defining prediabetes and diabetes. HbA1c test performance was assessed using receiver operating characteristic curve, with the optimal cutoff determined by Maximum Youden index. Propensity score matching with 0.02 calipers and nearest neighbor method was used to balance confounding factors between groups. <b><i>Results:</i></b> Of the participants, 238 (47.13%) were populations with recent high-altitude residential history (HA group), and 267 (52.87%) were low-altitude dwellers (LA group). The HA group had slightly higher HbA1c levels (<i>p</i> > 0.05) and higher erythrocyte and hemoglobin levels (<i>p</i> < 0.05), compared to the LA group. Weak correlations between prediabetes and HbA1c levels were observed in the HA group (<i>r</i><sub>s</sub> = 0.21, <i>p</i> < 0.05) and the LA group (<i>r</i><sub>s</sub> = 0.07, <i>p</i> = 0.25). The optimal cutoff for the detection of diabetes was 6.5% (area under the curve [AUC] 0.94) in the HA group and 5.9% (AUC 0.97) in the LA group, which remained unchanged after adjustment for confounders. <b><i>Conclusions:</i></b> The optimal cutoff of HbA1c for the detection of diabetes in populations with recent history of living at high altitude was higher than that in general populations living at low altitude, and the diagnostic value of HbA1c for prediabetes was also inadequate.</p>\",\"PeriodicalId\":12975,\"journal\":{\"name\":\"High altitude medicine & biology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"High altitude medicine & biology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/ham.2024.0030\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"BIOPHYSICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"High altitude medicine & biology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/ham.2024.0030","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"BIOPHYSICS","Score":null,"Total":0}
Influence of High-Altitude Residential History on Optimal HbA1c Cutoff for Detecting Abnormal Glucose Metabolism.
Aims: To explore the influence of recent high-altitude residential history on the optimal cutoff of glycosylated hemoglobin (HbA1c) for detecting abnormal glucose metabolism. Methods: The study included 505 self-reported healthy Han participants of age 18-65 years, recruited in Chengdu and categorized based on recent (within 3 months) high-altitude (>2,500 m) residential history. The 1999 WHO criteria was used as the gold standard for defining prediabetes and diabetes. HbA1c test performance was assessed using receiver operating characteristic curve, with the optimal cutoff determined by Maximum Youden index. Propensity score matching with 0.02 calipers and nearest neighbor method was used to balance confounding factors between groups. Results: Of the participants, 238 (47.13%) were populations with recent high-altitude residential history (HA group), and 267 (52.87%) were low-altitude dwellers (LA group). The HA group had slightly higher HbA1c levels (p > 0.05) and higher erythrocyte and hemoglobin levels (p < 0.05), compared to the LA group. Weak correlations between prediabetes and HbA1c levels were observed in the HA group (rs = 0.21, p < 0.05) and the LA group (rs = 0.07, p = 0.25). The optimal cutoff for the detection of diabetes was 6.5% (area under the curve [AUC] 0.94) in the HA group and 5.9% (AUC 0.97) in the LA group, which remained unchanged after adjustment for confounders. Conclusions: The optimal cutoff of HbA1c for the detection of diabetes in populations with recent history of living at high altitude was higher than that in general populations living at low altitude, and the diagnostic value of HbA1c for prediabetes was also inadequate.
期刊介绍:
High Altitude Medicine & Biology is the only peer-reviewed journal covering the medical and biological issues that impact human life at high altitudes. The Journal delivers critical findings on the impact of high altitude on lung and heart disease, appetite and weight loss, pulmonary and cerebral edema, hypertension, dehydration, infertility, and other diseases. It covers the full spectrum of high altitude life sciences from pathology to human and animal ecology.