Usefulness of Glycated Hemoglobin as Diagnostic Criteria for Metabolic Syndrome

Abstract

The metabolic syndrome (MetS) is the clustering of cardiovascular risk factors and known as a powerful predictor of diabetes and cardiovascular disease. Glycated hemoglobin (HbA1c) is used as one of the diagnostic criteria for diabetes and category of increased risk for diabetes. We examined the usefulness of HbA1c as a diagnostic tool for MetS and to determine the cut-off value of HbA1c as a criterion for MetS, in non-diabetic Korean subjects. We analyzed 7,307 participants (male: 4,181, 57%) in a medical check-up program, and applied the newly recommended guidelines of the International Diabetes Federation for diagnosis of MetS. The mean HbA1c was 5.54% in all subjects and showed no significant difference between genders. Using receiver-operating characteristic curve, HbA1c value corresponding to the fasting plasma glucose value of 100 mg/dL was 5.65% (sensitivity 52.3%, specificity 76.7%). The prevalence of MetS was 8.5% according to the IDF guideline and 10.9% according to HbA1c value of 5.7%, showing 69.5% agreement rate. The detection rate of MetS increased to 25.7% using the HbA1c criterion of 5.7% instead of fasting hyperglycemia. This study suggests that HbA1c might be used as a diagnostic criterion for MetS and the appropriate cut-off value of HbA1c may be 5.65% in this Korean population.

Hemoglobin A1c Is Positively Correlated with Framingham Risk Score in Older, Apparently Healthy Nondiabetic Korean Adults

“…This hypothesis suggests that HbA1c levels reflect CVD risk in middle-aged nondiabetic Korean adults, even though their HbA1c levels are generally considered to be within a normal range. Some studies have suggested the usefulness of HbA1c as a predictor of metabolic syndrome, defined as a cluster of closely related CVD risk factors such as obesity, dyslipidemia, hypertension, and hyperglycemia [27,28]. In our study, dyslipidemia and obesity was observed in UT subjects within the normal glucose tolerance range of HbA1c, while those in the IRD group were comparable with the MT and LT groups.…”

Metabolic Syndrome Including Glycated Hemoglobin A1c in Adults: Is It Time to Change?

“…Recent studies have shown HbA1c levels between 5.45% and 5.65% to be predictors of MetS in non-diabetic subjects [38,39]. Our study examined the suitability of the IDF-modified criteria that include, according with the prediabetes ADA criterion [15], an HbA1 level of 5.7% as a cut-off criterion, which would replace FPG as a dysglycemia indicator.…”

Glycated Hemoglobin, Fasting Insulin and the Metabolic Syndrome in Males. Cross-Sectional Analyses of the Aragon Workers’ Health Study Baseline

“…Some researchers have tried to substitute HbA1c for the glucose metabolic syndrome criterion or to add HbA1c as an additional diagnostic criterion [ 8 , 10 – 13 ]. Succurro et al[ 8 ] pointed out that, in their analysis, the metabolic syndrome using an HbA1c criterion instead of glucose performed worse in detecting some subjects who still had an unfavorable cardiometabolic risk profile.…”