Glycated hemoglobin and incident type 2 diabetes in singaporean chinese adults: the Singapore Chinese health study

• Published in: PloS one Vol. 10; no. 3; p. e0119884
• Main Authors: Bancks, Michael P, Odegaard, Andrew O, Koh, Woon-Puay, Yuan, Jian-Min, Gross, Myron D, Pereira, Mark A
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.03.2015; Public Library of Science (PLoS)
• Subjects: Adults; Aged; Alcohol use; Analysis; Biomarkers; Body mass index; Cancer; Cardiovascular diseases; Cohort Studies; Confidence intervals; Data analysis; Data processing; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diagnostic systems; Epidemiology; Ethanol; Family medical history; Fasting; Female; Glucose; Glycated Hemoglobin A - analysis; Glycosylated hemoglobin; Health risks; Hemoglobin; Humans; Incidence; Laboratories; Liquor; Male; Medical diagnosis; Men; Middle Aged; Population; Proportional Hazards Models; Public health; Regression analysis; Regression models; Singapore - epidemiology; Statistical analysis; Type 2 diabetes; Womens health; Singapore; Pittsburgh Pennsylvania; Asia; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0119884

The American Diabetes Association recently included glycated hemoglobin in the diagnostic criteria for diabetes, but research on the utility of this biomarker in Southeast Asians is scant. The aim of this study was to evaluate the association between percent HbA1c and incident diabetes in an Asian population of adult men and women without reported diabetes. Data analysis of 5,770 men and women enrolled in the Singapore Chinese Health Study who provided a blood sample at the follow-up I visit (1999-2004) and had no cancer and no reported history of diabetes or cardiovascular disease events. Diabetes was defined as self-report of physician diagnosis, identified at the follow-up II visit (2006-2010). Hazard ratios (and 95% confidence intervals) for incident diabetes by 5 categories of HbA1c were estimated with Cox regression models and continuous HbA1c with cubic spline analysis. Compared to individuals with an HbA1c ≤ 5.7% (≤39 mmol/mol), individuals with HbA1c 5.8-5.9% (40-41 mmol/mol), 6.0-6.1% (42-43 mmol/mol), 6.2-6.4% (44-47 mmol/mol), and ≥ 6.5% (≥48 mmol/mol) had significantly increased risk for incident diabetes during follow-up. In cubic spline analysis, levels below 5.7% HbA1c were not significantly associated with incident diabetes. Our study found a strong and graded association with HbA1c 5.8% and above with incident diabetes in Chinese men and women.