Low concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in overweight or obesity

Kyriazoula Chatzianagnostou, Luisella Vigna, Silvana Di Piazza, Amedea Silvia Tirelli, Filomena Napolitano, Laura Tomaino, Fabrizia Bamonti, Irene Traghella, Cristina Vassalle

Research output: Contribution to journalArticle

Abstract

Background: Glycated haemoglobin (HbA1c) test, introduced for diagnosing prediabetes and diabetes by the American Diabetes Association for some years, is currently under extensive discussion for contradictory data on the concordance between this test and the oral glucose tolerance test (OGTT). Hypothesis: To assess concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in subjects with overweight or obesity, focusing on possible gender-related differences. Methods: A total of 949 outpatients with overweight or obesity at risk for diabetes (mean age 50 ± 15 years; 660 F) were enrolled and underwent HbA1c test and OGTT. Results: In both genders, HbA1c test identified more patients with prediabetes than OGTT (42% vs 22% in males, 40% vs 18% in females, respectively): a slight concordance between HbA1c and OGTT (60% of total tests in both genders). In subjects diagnosed by OGTT, post-OGTT insulin levels and HOMA INDEX were significantly higher than those found in HbA1c(+) cases. Instead, those diagnosed with HbA1c were significantly older and showed higher uric acid than those with both tests (−). Conclusions: HbA1c test and OGTT did not reach full concordance for the diagnosis of diabetes and prediabetes in both genders. The two tests likely reflect different physiopathological aspects of dysglycaemia, suggesting that the ‘diagnostic thresholds’ could be reconsidered in light of the discordance observed.

Original languageEnglish
Pages (from-to)411-416
JournalClinical Endocrinology
Volume91
Issue number3
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Prediabetic State
Glucose Tolerance Test
Obesity
Glycosylated Hemoglobin A
Uric Acid
Outpatients
Insulin

Keywords

  • gender
  • HbA1c
  • obesity
  • OGTT
  • overweight
  • prediabetes
  • type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Low concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in overweight or obesity. / Chatzianagnostou, Kyriazoula; Vigna, Luisella; Di Piazza, Silvana; Tirelli, Amedea Silvia; Napolitano, Filomena; Tomaino, Laura; Bamonti, Fabrizia; Traghella, Irene; Vassalle, Cristina.

In: Clinical Endocrinology, Vol. 91, No. 3, 01.01.2019, p. 411-416.

Research output: Contribution to journalArticle

Chatzianagnostou, K, Vigna, L, Di Piazza, S, Tirelli, AS, Napolitano, F, Tomaino, L, Bamonti, F, Traghella, I & Vassalle, C 2019, 'Low concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in overweight or obesity', Clinical Endocrinology, vol. 91, no. 3, pp. 411-416. https://doi.org/10.1111/cen.14043
Chatzianagnostou, Kyriazoula ; Vigna, Luisella ; Di Piazza, Silvana ; Tirelli, Amedea Silvia ; Napolitano, Filomena ; Tomaino, Laura ; Bamonti, Fabrizia ; Traghella, Irene ; Vassalle, Cristina. / Low concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in overweight or obesity. In: Clinical Endocrinology. 2019 ; Vol. 91, No. 3. pp. 411-416.
@article{d746a0d26c564bf2b940939af2b3e5c3,
title = "Low concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in overweight or obesity",
abstract = "Background: Glycated haemoglobin (HbA1c) test, introduced for diagnosing prediabetes and diabetes by the American Diabetes Association for some years, is currently under extensive discussion for contradictory data on the concordance between this test and the oral glucose tolerance test (OGTT). Hypothesis: To assess concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in subjects with overweight or obesity, focusing on possible gender-related differences. Methods: A total of 949 outpatients with overweight or obesity at risk for diabetes (mean age 50 ± 15 years; 660 F) were enrolled and underwent HbA1c test and OGTT. Results: In both genders, HbA1c test identified more patients with prediabetes than OGTT (42{\%} vs 22{\%} in males, 40{\%} vs 18{\%} in females, respectively): a slight concordance between HbA1c and OGTT (60{\%} of total tests in both genders). In subjects diagnosed by OGTT, post-OGTT insulin levels and HOMA INDEX were significantly higher than those found in HbA1c(+) cases. Instead, those diagnosed with HbA1c were significantly older and showed higher uric acid than those with both tests (−). Conclusions: HbA1c test and OGTT did not reach full concordance for the diagnosis of diabetes and prediabetes in both genders. The two tests likely reflect different physiopathological aspects of dysglycaemia, suggesting that the ‘diagnostic thresholds’ could be reconsidered in light of the discordance observed.",
keywords = "gender, HbA1c, obesity, OGTT, overweight, prediabetes, type 2 diabetes",
author = "Kyriazoula Chatzianagnostou and Luisella Vigna and {Di Piazza}, Silvana and Tirelli, {Amedea Silvia} and Filomena Napolitano and Laura Tomaino and Fabrizia Bamonti and Irene Traghella and Cristina Vassalle",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/cen.14043",
language = "English",
volume = "91",
pages = "411--416",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Low concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in overweight or obesity

AU - Chatzianagnostou, Kyriazoula

AU - Vigna, Luisella

AU - Di Piazza, Silvana

AU - Tirelli, Amedea Silvia

AU - Napolitano, Filomena

AU - Tomaino, Laura

AU - Bamonti, Fabrizia

AU - Traghella, Irene

AU - Vassalle, Cristina

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Glycated haemoglobin (HbA1c) test, introduced for diagnosing prediabetes and diabetes by the American Diabetes Association for some years, is currently under extensive discussion for contradictory data on the concordance between this test and the oral glucose tolerance test (OGTT). Hypothesis: To assess concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in subjects with overweight or obesity, focusing on possible gender-related differences. Methods: A total of 949 outpatients with overweight or obesity at risk for diabetes (mean age 50 ± 15 years; 660 F) were enrolled and underwent HbA1c test and OGTT. Results: In both genders, HbA1c test identified more patients with prediabetes than OGTT (42% vs 22% in males, 40% vs 18% in females, respectively): a slight concordance between HbA1c and OGTT (60% of total tests in both genders). In subjects diagnosed by OGTT, post-OGTT insulin levels and HOMA INDEX were significantly higher than those found in HbA1c(+) cases. Instead, those diagnosed with HbA1c were significantly older and showed higher uric acid than those with both tests (−). Conclusions: HbA1c test and OGTT did not reach full concordance for the diagnosis of diabetes and prediabetes in both genders. The two tests likely reflect different physiopathological aspects of dysglycaemia, suggesting that the ‘diagnostic thresholds’ could be reconsidered in light of the discordance observed.

AB - Background: Glycated haemoglobin (HbA1c) test, introduced for diagnosing prediabetes and diabetes by the American Diabetes Association for some years, is currently under extensive discussion for contradictory data on the concordance between this test and the oral glucose tolerance test (OGTT). Hypothesis: To assess concordance between HbA1c and OGTT to diagnose prediabetes and diabetes in subjects with overweight or obesity, focusing on possible gender-related differences. Methods: A total of 949 outpatients with overweight or obesity at risk for diabetes (mean age 50 ± 15 years; 660 F) were enrolled and underwent HbA1c test and OGTT. Results: In both genders, HbA1c test identified more patients with prediabetes than OGTT (42% vs 22% in males, 40% vs 18% in females, respectively): a slight concordance between HbA1c and OGTT (60% of total tests in both genders). In subjects diagnosed by OGTT, post-OGTT insulin levels and HOMA INDEX were significantly higher than those found in HbA1c(+) cases. Instead, those diagnosed with HbA1c were significantly older and showed higher uric acid than those with both tests (−). Conclusions: HbA1c test and OGTT did not reach full concordance for the diagnosis of diabetes and prediabetes in both genders. The two tests likely reflect different physiopathological aspects of dysglycaemia, suggesting that the ‘diagnostic thresholds’ could be reconsidered in light of the discordance observed.

KW - gender

KW - HbA1c

KW - obesity

KW - OGTT

KW - overweight

KW - prediabetes

KW - type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=85067493321&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067493321&partnerID=8YFLogxK

U2 - 10.1111/cen.14043

DO - 10.1111/cen.14043

M3 - Article

C2 - 31152677

AN - SCOPUS:85067493321

VL - 91

SP - 411

EP - 416

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 3

ER -