Published online Jul 15, 2024. doi: 10.4239/wjd.v15.i7.1531
Revised: April 25, 2024
Accepted: May 23, 2024
Published online: July 15, 2024
Processing time: 199 Days and 0.9 Hours
Glycated hemoglobin A1c (HbA1c) is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience. However, the effect of HbA1c on diabetic retinopathy (DR) in the Han and Korean populations in Jilin, China, remains inconclusive.
To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.
This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province, China. Trained investigators employed a questionnaire-based survey, physical examination, laboratory tests, and fundus photography for the investigation. The best cut-off value for HbA1c was established via the receiver operating characteristic curve. The factors associated with HbA1c-associated risk factors were determined via linear regression.
The analysis included 887 eligible Chinese Han and Korean participants, 591 of whom were assigned randomly to the training set and 296 to the validation set. The prevalence of DR was 3.27% in the total population. HbA1c of 6.2% was the best cut-off value in the training set, while it was 5.9% in the validation set. In both Chinese Han and Korean populations, an HbA1c level of 6.2% was the best cut-off value. The optimal cut-off values of fasting blood glucose (FBG) ≥ 7 mmol/L and < 7 mmol/L were 8.1% and 6.2% respectively in Han populations, while those in Korean populations were 6.9% and 5.3%, respectively. Age, body mass index, and FBG were determined as the risk factors impacting HbA1c levels.
HbA1c may serve as a useful diagnostic indicator for DR. An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.
Core Tip: This cross-sectional analysis of data from 887 participants in Yanbian area of China from March to April 2017 determined the best glycated hemoglobin A1c (HbA1c) cut-off point for the diagnosis of diabetic retinopathy (DR) among the Chinese population. This study implies that HbA1c is a practical diagnostic marker for DR, and an HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.