A comparison in the ability to detect diabetic retinopathy between fasting plasma glucose and HbA1c levels in a longitudinal study
Aims The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population. Materials and Metho...
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Published in | Endocrinology, Diabetes & Metabolism Vol. 4; no. 1; pp. e00196 - n/a |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Wiley
01.01.2021
John Wiley & Sons, Inc John Wiley and Sons Inc |
Subjects | |
Online Access | Get full text |
ISSN | 2398-9238 2398-9238 |
DOI | 10.1002/edm2.196 |
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Abstract | Aims
The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population.
Materials and Methods
The study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008‐2009 (baseline) and in 2012‐2013 (4‐year follow‐up). Both non‐DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow‐up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy.
Results
The odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14‐28.26), 1.69 (0.24‐12.04), 3.03 (0.50‐18.28), 1.04 (0.09‐11.59), 4.73 (0.78‐28.69), 4.12 (0.74‐22.85) and 24.47 (5.61‐106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048).
Conclusions
It was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only.
A comparison in the ability to detect diabetic retinopathy between fasting plasma glucose and HbA1c levels in a longitudinal study. |
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AbstractList | A comparison in the ability to detect diabetic retinopathy between fasting plasma glucose and HbA1c levels in a longitudinal study. The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population. The study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008-2009 (baseline) and in 2012-2013 (4-year follow-up). Both non-DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow-up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy. The odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14-28.26), 1.69 (0.24-12.04), 3.03 (0.50-18.28), 1.04 (0.09-11.59), 4.73 (0.78-28.69), 4.12 (0.74-22.85) and 24.47 (5.61-106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048). It was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only. Aims The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population. Materials and Methods The study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008‐2009 (baseline) and in 2012‐2013 (4‐year follow‐up). Both non‐DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow‐up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy. Results The odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14‐28.26), 1.69 (0.24‐12.04), 3.03 (0.50‐18.28), 1.04 (0.09‐11.59), 4.73 (0.78‐28.69), 4.12 (0.74‐22.85) and 24.47 (5.61‐106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048). Conclusions It was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only. A comparison in the ability to detect diabetic retinopathy between fasting plasma glucose and HbA1c levels in a longitudinal study. AimsThe relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population.Materials and MethodsThe study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008‐2009 (baseline) and in 2012‐2013 (4‐year follow‐up). Both non‐DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow‐up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy.ResultsThe odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14‐28.26), 1.69 (0.24‐12.04), 3.03 (0.50‐18.28), 1.04 (0.09‐11.59), 4.73 (0.78‐28.69), 4.12 (0.74‐22.85) and 24.47 (5.61‐106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048).ConclusionsIt was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only. The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population.AimsThe relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population.The study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008-2009 (baseline) and in 2012-2013 (4-year follow-up). Both non-DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow-up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy.Materials and MethodsThe study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008-2009 (baseline) and in 2012-2013 (4-year follow-up). Both non-DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow-up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy.The odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14-28.26), 1.69 (0.24-12.04), 3.03 (0.50-18.28), 1.04 (0.09-11.59), 4.73 (0.78-28.69), 4.12 (0.74-22.85) and 24.47 (5.61-106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048).ResultsThe odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14-28.26), 1.69 (0.24-12.04), 3.03 (0.50-18.28), 1.04 (0.09-11.59), 4.73 (0.78-28.69), 4.12 (0.74-22.85) and 24.47 (5.61-106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048).It was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only.ConclusionsIt was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only. Abstract Aims The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting plasma glucose (FPG) is more effective for detecting the diabetic retinopathy longitudinally in a Japanese population. Materials and Methods The study subjects underwent health examinations twice (including eye test and questionnaire of lifestyle and health) in 2008‐2009 (baseline) and in 2012‐2013 (4‐year follow‐up). Both non‐DM and DM patients at baseline were included as the participants. Of these participants, who had not been diagnosed with retinopathy at the baseline survey (n = 2427; 2150 men and 277 women) had eye fundus photographs taken four years later (follow‐up survey). The odds ratios of incidence of retinopathy according to the eight groups of FPG and HbA1c were estimated using multiple logistic regression analysis adjusted for sex and age. Receiver operator characteristic analysis was used to evaluate each value associated with the presence or absence of retinopathy. Results The odds ratios (95% confidence intervals) of incidence of retinopathy by HbA1c level categories, in ascending order, were 1.0 (ref.), 5.66 (1.14‐28.26), 1.69 (0.24‐12.04), 3.03 (0.50‐18.28), 1.04 (0.09‐11.59), 4.73 (0.78‐28.69), 4.12 (0.74‐22.85) and 24.47 (5.61‐106.75). For both FPG and HbA1c levels, the odds ratio for the development of retinopathy increased linearly with the increases in the levels FPG and HbA1c, and no clear threshold was observed. The AUC values (SE) for FPG and HbA1c were almost the same, at 0.750 (0.046) and 0.732 (0.048). Conclusions It was clarified that the higher the level of FPG and HbA1c was, the higher the incidence of retinopathy after 4 years was. There was no clear threshold. The detection ability of the incidence of retinopathy was almost the same between FPG and HbA1c, suggesting it is possible to detect the risk of retinopathy by HbA1c only. |
Author | Shuichiro Yamamoto Tetsuji Yokoyama Naotatsu Katai Norio Takeda Yosuke Nakamura Mitsuhiko Noda Yumi Matsushita Natsuyo Yoshida‐Hata Tetsuya Mizoue Toru Nakagawa |
AuthorAffiliation | 3 Takeda Eye Clinic Chiba Japan 5 Hikaru Eye Clinic Saitama Japan 1 Department of Clinical Research National Center for Global Health and Medicine Tokyo Japan 4 Department of ophthalmology Shimoda Medical Center Shizuoka Japan 8 Department of Diabetes, Metabolism and Endocrinology Ichikawa Hospital International University of Health and Welfare Chiba Japan 2 Department of Health Promotion National Institute of Public Health Saitama Japan 7 Hitachi, Ltd. Hitachi Health Care Center Ibaraki Japan 9 Department of Epidemiology and Prevention National Center for Global Health and Medicine Tokyo Japan 6 Department of ophthalmology Kimitsu Chuo Hospital Chiba Japan |
AuthorAffiliation_xml | – name: 9 Department of Epidemiology and Prevention National Center for Global Health and Medicine Tokyo Japan – name: 4 Department of ophthalmology Shimoda Medical Center Shizuoka Japan – name: 5 Hikaru Eye Clinic Saitama Japan – name: 7 Hitachi, Ltd. Hitachi Health Care Center Ibaraki Japan – name: 6 Department of ophthalmology Kimitsu Chuo Hospital Chiba Japan – name: 2 Department of Health Promotion National Institute of Public Health Saitama Japan – name: 3 Takeda Eye Clinic Chiba Japan – name: 8 Department of Diabetes, Metabolism and Endocrinology Ichikawa Hospital International University of Health and Welfare Chiba Japan – name: 1 Department of Clinical Research National Center for Global Health and Medicine Tokyo Japan |
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Notes | This study was supported by grants from the Ministry of Health, Labor and Welfare of Japan and the Ministry of Education, Culture, Sports, Science and Technology of Japan, and Grants‐in‐Aid for Research from the National Center for Global Health and Medicine (20A‐3002). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 Funding information |
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References_xml | – volume: 21 start-page: 1323 issue: 308 year: 1994 end-page: 1328 article-title: Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes publication-title: BMJ – volume: 18 year: 2016 article-title: Optimal glycemic and hemoglobin A1c thresholds for diagnosing diabetes based on prevalence of retinopathy in an Iranian population publication-title: Iran Red Crescent Med J – volume: 148 start-page: 111 year: 2009 end-page: 118 article-title: Screening for diabetic retinopathy: 1 and 3 nonmydriatic 45‐degree digital fundus photographs vs 7 standard early treatment diabetic retinopathy study fields publication-title: Am J Ophthalmol – volume: 50 start-page: 837 year: 2013 end-page: 842 article-title: Optimal HbA1c cutoff for detecting diabetic retinopathy publication-title: Acta Diabetol – volume: 28 issue: 11 year: 2016 article-title: The accuracy of diagnostic methods for diabetic retinopathy: a systematic review and meta‐analysis publication-title: PLoS One – volume: 61 start-page: 3280 year: 2012 end-page: 3284 article-title: New diabetes diagnostic threshold of hemoglobin A1c and the 3‐year incidence of retinopathy publication-title: Diabetes – volume: 124 start-page: 20 year: 2017 end-page: 29 article-title: Diabetes diagnostic thresholds of the glycated hemoglobin A1c and fasting plasma glucose levels considering the 5‐year incidence of retinopathy publication-title: Diabetes Res Clin Pract – volume: 32 start-page: 2027 year: 2009 end-page: 2032 article-title: Association of A1C and fasting plasma glucose levels with diabetic retinopathy prevalence in the U.S. population: implications for diabetes diagnostic thresholds publication-title: Diabetes Care – volume: 11 start-page: 1675 year: 2003 end-page: 1676 article-title: A simplified diabetic retinopathy scale publication-title: Ophthalmology – year: 2006 – volume: 20 start-page: 785 year: 1997 end-page: 791 article-title: Comparison of fasting and 2‐hour glucose and HbA1c levels for diagnosing diabetes. diagnostic criteria and performance revisited publication-title: Diabetes Care – volume: 32 start-page: 1327 year: 2009 end-page: 1334 article-title: International Expert Committee. International Expert Committee Report on the Role of the A1C Assay in the diagnosis of diabetes publication-title: Diabetes Care – volume: 21 start-page: 1414 year: 1998 end-page: 1431 article-title: Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections publication-title: Diabetes Care – year: 1991 – year: 2019 – volume: 104 start-page: 435 year: 2014 end-page: 442 article-title: Glycaemic and haemoglobin A1c thresholds for detecting diabetic retinopathy: the Fifth Korea National Health and Nutrition Examination Survey (2011) publication-title: Diabetes Res Clin Pract – ident: e_1_2_7_11_1 doi: 10.2337/dc09-0440 – ident: e_1_2_7_15_1 doi: 10.1016/j.diabres.2016.12.013 – volume: 28 start-page: e0154411 issue: 11 year: 2016 ident: e_1_2_7_12_1 article-title: The accuracy of diagnostic methods for diabetic retinopathy: a systematic review and meta‐analysis publication-title: PLoS One doi: 10.1371/journal.pone.0154411 – ident: e_1_2_7_8_1 doi: 10.1007/s00592-013-0452-3 – ident: e_1_2_7_4_1 doi: 10.2337/dc09-9033 – ident: e_1_2_7_17_1 doi: 10.1016/j.ajo.2009.02.031 – ident: e_1_2_7_14_1 doi: 10.1136/bmj.308.6940.1323 – ident: e_1_2_7_10_1 doi: 10.1016/j.diabres.2014.04.003 – ident: e_1_2_7_9_1 doi: 10.5812/ircmj.31254 – ident: e_1_2_7_16_1 doi: 10.2337/db12-0103 – ident: e_1_2_7_13_1 doi: 10.2337/diacare.20.5.785 – volume-title: IDF Diabetes Atlas year: 2019 ident: e_1_2_7_3_1 – volume-title: Clinical Epidemology. How to Do Clinical Practice Research year: 2006 ident: e_1_2_7_6_1 – ident: e_1_2_7_2_1 doi: 10.2337/diacare.21.9.1414 – ident: e_1_2_7_5_1 doi: 10.1016/S0161-6420(03)00815-7 – volume-title: Clinical Epidemology: A Basic Science for Clinical Medicine year: 1991 ident: e_1_2_7_7_1 |
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The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and... The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and fasting... AimsThe relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c and... A comparison in the ability to detect diabetic retinopathy between fasting plasma glucose and HbA1c levels in a longitudinal study. Abstract Aims The relationship between HbA1c and diabetic retinopathy is expected to differ between different races. In this study, we verified which of HbA1c... |
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SubjectTerms | Age Asian People Biomarkers Biomarkers - blood Blood Glucose Blood pressure Committees Diabetes Diabetic Retinopathy Diabetic Retinopathy - blood Diabetic Retinopathy - diagnosis Diabetic Retinopathy - epidemiology Disease Diseases of the endocrine glands. Clinical endocrinology Fasting Fasting - blood fasting plasma glucose Female Follow-Up Studies Glucose Glycated Hemoglobin HbA1c Hemoglobin Humans Logistic Models Longitudinal Studies longitudinal study Male Medical personnel Original Original s Plasma RC648-665 retinopathy Risk ROC Curve |
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Title | A comparison in the ability to detect diabetic retinopathy between fasting plasma glucose and HbA1c levels in a longitudinal study |
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