Comparing HbA_(1c), fasting and 2-h plasma glucose for screening for abnormal glucose regulation in patients undergoing coronary angiography

摘要

Background: We aimed to investigate the prevalence of undiagnosed abnormal glucose regulation (AGR, including diabetes and prediabetes) in patients undergoing coronary angiography (CAG) by using both glycated hemoglobin (HbA_(1c)) and oral glucose tolerance test (OGTT) to screen, and to compare the performance of fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), and HbA_(1c) for screening for AGR.Methods: Eligible patients were adults without known diabetes who were admitted for CAG. Patients' glucose regulation status was defined by conducting HbA_(1c) and OGTT 2-4 weeks after hospital discharge. The performance of FPG, 2hPG, and HbA_(1c) for detecting AGR was evaluated using receiver operating characteristic (ROC) analysis. Results: A total of 689 subjects were included. According to OGTT, the prevalence rates of diabetes and prediabetes were 19.9% and 41.7%, respectively. The corresponding values were 28.0% and 60.4%, respectively, when HbA_(1c) was adopted as a diagnostic criterion in addition to OGTT. For detecting diabetes, the area under the ROC curve (AUC) was higher for HbA_(1c) than for FPG (0.87 vs. 0.80, p=0.005), but was not significantly different from that for 2hPG (0.87 vs. 0.88, p=0.58). For detecting AGR, the AUC was higher for HbA_(1c) than for either FPG (0.94 vs. 0.74, p<0.001) or 2hPG (0.94 vs. 0.83, p<0.001).Conclusions: Using HbA_(1c) and OGTT to screen, we reported an extremely high prevalence of previously undiagnosed AGR (28.0% diabetes and 60.4% prediabetes) in patients admitted for CAG. HbA_(1c) may be adopted as an alternative to OGTT for screening for AGR in patients undergoing CAG.