Consensus Statement on the Worldwide Standardization of the Hemoglobin A1C Measurement

Kahn, Richard; Hicks, Jocelyn M.; Müller, Mathias M.; Panteghini, Mauro; John, Garry; Deeb, Larry C.; Buse, John B.; Nathan, David M.; Ferrannini, Ele; Heine, Robert J.; Silink, Martin; Mbanya, Jean Claude

doi:10.2337/dc07-9925

Cited by 262 publications

(46 citation statements)

References 12 publications

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“…Indeed, in the Japanese-Americans study [24], HbA 1c had a much higher mean than in other studies. HbA 1c was assayed over a long time period, and the techniques used were certainly not aligned with the recent International Federation of Clinical Chemistry standard [30], although the assays for some studies were aligned with the National Glycohemoglobin Standardization Program (NGSP) that was used for the DCCT and the UKPDS [31, 32]. However, as commented above , for the main analyses shown on the forest plots, we are dealing with differences within centres in comparison to never-smokers .…”

Section: Discussionmentioning

confidence: 99%

HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis

et al. 2013

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Aim The relations between smoking and glycaemic parameters are not well explored. We compare HbA1c, fasting plasma glucose (FPG) and 2-hour plasma glucose (2H-PG) in current-, ex- and never-smokers. Methods This meta-analysis used individual data from 16 886 men and 18 539 women without known diabetes, in 12 DETECT-2 consortium studies and in the French D.E.S.I.R. and TELECOM studies. Means of the three glycaemic parameters in current-, ex- and never-smokers were modelled by linear regression, with study as a random factor. The I2 statistic evaluated heterogeneity among studies. Results HbA1c was 0.10 (95%CI:0.08,0.12) % [1.1 (0.9,1.3) mmol/mol] higher in current-smokers and 0.03 (0.01,0.05) % [0.3 (0.1,0.5) mmol/l] higher in ex-smokers, compared with never-smokers. For FPG, there was no significant difference between current- and never-smokers: −0.004 (−0.03,0.02) mmol/l but FPG was higher in ex-smokers: 0.12 (0.09,0.14) mmol/l. In comparison to never-smokers, 2H-PG was lower: −0.44 (−0.52,−0.37) mmol/l in current-smokers, with no difference for ex-smokers: 0.02 (−0.06,0.09) mmol/l. There was a large and unexplained heterogeneity among studies, with I2 always higher than 50%: after stratification by sex and adjustment for age and BMI, I2 changed little. In this study population, current-smokers had a prevalence of diabetes as screened by HbA1c, 1.30% higher and that screened by 2H-PG, 0.52% lower than in comparison to never-smokers. Conclusion Current-smokers had a higher HbA1c and a lower 2H-PG than never-smokers, across this heterogeneous group of studies; this will effect the chances of smokers being diagnosed with diabetes.

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Section: Discussionmentioning

confidence: 99%

HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis

et al. 2013

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“…Third, since there was no information on the participants’ smoking status, atrial fibrillation, family history and history of cerebrocardiovascular diseases, no adjustment was made for these factors when calculating hazard ratios. Finally, the need to standardize the method for measuring HbA 1c levels has been pointed out [26]. However, in the present study, the method was standardized by the Japan Diabetes Society.…”

Section: Discussionmentioning

confidence: 99%

Glycated Hemoglobin and Risk of Stroke, Ischemic and Hemorrhagic, in Japanese Men and Women

et al. 2008

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Background: The relationship between glycated hemoglobin A_1c (HbA_1c) and stroke has not been fully elucidated. In addition, there have been few reports from Asia, and few trials have been conducted for each stroke subtype. Methods: A prospective cohort study was performed involving 32,726 participants (9,558 men and 23,168 women) aged 40–79 years at baseline with approximately 6 years of follow-up in a general population of Japan. The end points included the incidence of all, ischemic and hemorrhagic strokes. Multivariate-adjusted hazard ratios by 6 HbA_1c categories were calculated using a Cox proportional hazard model. Results: During the follow-up, 393 participants developed a stroke, including 240 ischemic and 139 hemorrhagic stroke cases. The adjusted hazard ratios of all strokes and ischemic stroke showed tendencies to increase with HbA_1c level, and the relationships were independent of other confounders. The adjusted hazard ratios of ischemic stroke incidence showed an apparent and graded increase from a relatively mild HbA_1c level (≧6.0%); the HRs (95% CI) were 1.79 (1.10–2.93) for HbA_1c 6.0–6.4%, 2.20 (1.21–4.00) for HbA_1c 6.5–6.9% and 2.91 (1.91–4.44) for HbA_1c ≧7.0% compared with the category of HbA_1c 5.0–5.4%. For hemorrhagic stroke incidence, no significant increase due to rises in HbA_1c level was observed. Conclusions: The relationship of the risk of stroke, especially ischemic stroke, to HbA_1c in the general population appears to be graded without any apparent threshold. The ischemic stroke risk would increase from a relatively mild HbA_1c level of ≧6.0%.

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“…Acute hyperglycemia was defined as a blood glucose level at admission >198 mg/dL (>11 mmol/L), according to the definition used in previous studies focusing on AMI patients 11, 14, 15, 16. Average chronic glucose levels were estimated by HbA 1c , expressed as percentage value, according to the following validated formula12, 13, 17:

Estimated chronic glucose levels false(mg false/ dL false) = 28.7 \times {HbA}_{1 c} false(% false) - 46.7

…”

Section: Methodsmentioning

confidence: 99%

Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia

Marenzi

Cosentino

Milazzo

et al. 2018

JAHA

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BackgroundIn acute myocardial infarction, acute hyperglycemia is a predictor of acute kidney injury (AKI), particularly in patients without diabetes mellitus. This emphasizes the importance of an acute glycemic rise rather than glycemia level at admission. We investigated whether, in diabetic patients with acute myocardial infarction, the combined evaluation of acute and chronic glycemic levels may have better prognostic value for AKI than admission glycemia.Methods and ResultsAt admission, we prospectively measured glycemia and estimated average chronic glucose levels (mg/dL) using glycosylated hemoglobin (HbA1c), according to the following formula: 28.7×HbA1c (%)−46.7. We evaluated the association with AKI of the acute/chronic glycemic ratio and of the difference between acute and chronic glycemia (ΔA−C). We enrolled 474 diabetic patients with acute myocardial infarction. Of them, 77 (16%) experienced AKI. The incidence of AKI increased in parallel with the acute/chronic glycemic ratio (12%, 14%, 22%; P=0.02 for trend) and ΔA−C (13%, 13%, 23%; P=0.01) but not with admission glycemic tertiles (P=0.22). At receiver operating characteristic analysis, the acute/chronic glycemic ratio (area under the curve: 0.62 [95% confidence interval, 0.55–0.69]; P=0.001) and ΔA−C (area under the curve: 0.62 [95% confidence interval, 0.54–0.69]; P=0.002) accurately predicted AKI, without difference in the area under the curve between them (P=0.53). At reclassification analysis, the addition of the acute/chronic glycemic ratio and ΔA−C to acute glycemia allowed proper AKI risk prediction in 16% of patients.ConclusionsIn diabetic patients with acute myocardial infarction, AKI is better predicted by the combined evaluation of acute and chronic glycemic values than by assessment of admission glycemia alone.

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Consensus Statement on the Worldwide Standardization of the Hemoglobin A1C Measurement

Cited by 262 publications

References 12 publications

HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis

HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis

Glycated Hemoglobin and Risk of Stroke, Ischemic and Hemorrhagic, in Japanese Men and Women

Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia

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