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Glycated haemoglobin (HbA1c ) and fasting plasma glucose relationships in sea-level and high-altitude settings

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dc.contributor.author Bazo-Alvarez, J. C.
dc.contributor.author Quispe, R.
dc.contributor.author Pillay, T. D.
dc.contributor.author Bernabe-Ortiz, A.
dc.contributor.author Smeeth, L.
dc.contributor.author Checkley, W.
dc.contributor.author Gilman, R. H.
dc.contributor.author Malaga, G.
dc.contributor.author Miranda, J. J.
dc.date.accessioned 2019-01-25T15:18:36Z
dc.date.available 2019-01-25T15:18:36Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4666
dc.description.abstract AIM: Higher haemoglobin levels and differences in glucose metabolism have been reported among high-altitude residents, which may influence the diagnostic performance of HbA1c . This study explores the relationship between HbA1c and fasting plasma glucose (FPG) in populations living at sea level and at an altitude of > 3000 m. METHODS: Data from 3613 Peruvian adults without a known diagnosis of diabetes from sea-level and high-altitude settings were evaluated. Linear, quadratic and cubic regression models were performed adjusting for potential confounders. Receiver operating characteristic (ROC) curves were constructed and concordance between HbA1c and FPG was assessed using a Kappa index. RESULTS: At sea level and high altitude, means were 13.5 and 16.7 g/dl (P > 0.05) for haemoglobin level; 41 and 40 mmol/mol (5.9% and 5.8%; P < 0.01) for HbA1c ; and 5.8 and 5.1 mmol/l (105 and 91.3 mg/dl; P < 0.001) for FPG, respectively. The adjusted relationship between HbA1c and FPG was quadratic at sea level and linear at high altitude. Adjusted models showed that, to predict an HbA1c value of 48 mmol/mol (6.5%), the corresponding mean FPG values at sea level and high altitude were 6.6 and 14.8 mmol/l (120 and 266 mg/dl), respectively. An HbA1c cut-off of 48 mmol/mol (6.5%) had a sensitivity for high FPG of 87.3% (95% confidence interval (95% CI) 76.5 to 94.4) at sea level and 40.9% (95% CI 20.7 to 63.6) at high altitude. CONCLUSION: The relationship between HbA1c and FPG is less clear at high altitude than at sea level. Caution is warranted when using HbA1c to diagnose diabetes mellitus in this setting. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof urn:issn:1464-5491
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Aged en_US
dc.subject Middle Aged en_US
dc.subject Longitudinal Studies en_US
dc.subject Geography en_US
dc.subject Altitude en_US
dc.subject Glycated Hemoglobin A/analysis en_US
dc.subject Blood Glucose/analysis en_US
dc.subject Diabetes Mellitus, Type 2/blood/diagnosis en_US
dc.subject Fasting/blood en_US
dc.subject Glucose Tolerance Test en_US
dc.title Glycated haemoglobin (HbA1c ) and fasting plasma glucose relationships in sea-level and high-altitude settings en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1111/dme.13335
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.27


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