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Effect of HbA1C detection on the diagnostic screening for glucose metabolic disorders in polycystic ovary syndrome
Yueqiao Zhen1,*, Peng Yang2, Ruihong Dong1, Yumin Wu1, Yanhong Sang1, Xiaoxiao Du1, Yan Wang1, Qiuyan Song1, Ling Yu1, Xiaojuan Rao1
1 Department of Endocrinology and Metabolism, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou
2 Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, affiliated to Tongji University, Shanghai (China)
Clin. Exp. Obstet. Gynecol. 2014, 41(1), 58–61; https://doi.org/10.12891/ceog16312014
Published: 10 February 2014
Purpose: This study aimed to assess the effect of hemoglobin A1C (HbA1C) detection on the diagnostic screening for glucose metabolic disorders in women with polycystic ovary syndrome (PCOS). Materials and Methods: A total of 161 patients with PCOS (mean age = 23.68 ± 4.23 years) were subjected to an oral glucose tolerance test (OGTT). The receiver operating characteristic (ROC) curve was plotted to evaluate the fasting plasma glucose (FPG), and HbA1C was used to probe the sensitivity and specificity of abnormal glucose tolerance. Results: Based on the traditional standards of blood sugar, the prevalence of type 2 diabetes was 5.6%, and the pre-diabetes prevalence was 7.5%. Based on the HbA1C standards, 4.3% of patients were diagnosed with type 2 diabetes, and 10.6% of the diabetic patients can be considered as high-risk populations. Based on the combined standards of OGTT and HbA1C, the prevalence of type 2 diabetes was 6.2%, and the pre-diabetes prevalence was 12.4%. OGTT is considered the gold standard for identifying abnormal glucose tolerance, and HbA1C detection is considered to be stronger than FPG. The areas under the ROC curves of HbA1C and FPG were 0.968 and 0.672, respectively (p < 0.01). The American Diabetes Association (ADA) recommends the cut-off value of HbAlc ≥ 5.7% and FPG ≥ 5.6 mmol/l for identifying abnormal glucose tolerance. The sensitivity and specificity were 76.7% and 89.5% for HBA1C, as well as 40.5% and 94.3% for FPG, respectively. The positive and negative likelihood ratios were 7.3 and 0.26 for HbA1C, as well as 7.1 and 0.63 for FPG, respectively. Conclusion: HbA1C detection can be used as a method for diagnosis and screening.
Polycystic ovary syndrome
Oral glucose tolerance test
Receiver operating characteristic curve