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연구배경: HbA1c는 2~3개월 동안의 혈당 조절 상태를 반영하는 수치로 최근 진단적 기준으로서의 유용성에 대해 서 많이 보고가 되고 있다. 이에 본 연구에서는 혈당이상이 의심되어 경구당부하검사를 시행한 1,482명의 대상자들에 게서 당뇨병을 예측하는 HbA1c의 cutoff 값을 분석하였다. 방법: 이전에 당뇨병, 공복혈당장애, 내당능장애를 진단 받은 적이 없었던 1,482명의 연구 대상자들에게서 HbA1c, 공복혈당농도, 경구당부하 120분 후 혈장포도당 농도를 측 정하였고 ROC curve를 이용하여 당뇨병을 예측하는 HbA1c 의 cutoff 값을 분석하였다. 결과: ROC 분석을 이용하여 당뇨병을 예측하는 HbA1c 를 분석하였을 때 cuttoff 값은 5.95% (sensitivity 60.8%, specificity 85.6%)였고 남자와 여자를 구분하여 분석하였을 때 HbA1c cutoff 값은 남자는 5.85%, 여자는 6.05%로 성 별에 따라 달랐다. 결론: HbA1c 측정이 이전에 당뇨병을 진단받지 않은 비 교적 건강한 한국인들에게서 당뇨병 발생을 예측하는데 유 용할 것으로 생각된다. 그러나 다른 인종들을 대상으로 한 연구들과 비교하였을 때 당뇨병을 예측하는 HbA1c cutoff 값에 차이가 있었으며 이는 당뇨병을 예측하는 방법으로서 HbA1c를 이용하는 데에는 다양한 집단의 다양한 연령, 성 별, 집단별 당뇨병 유병률 등이 고려되어야 함을 제시한다.


Background: Glycated hemoglobin (HbA1c) levels represent a 2~3 month average of blood glucose concentration. The use of HbA1c as a diagnostic tool for diabetes is gaining interest. Therefore, we determined the cutoff point of HbA1c for predicting abnormal glucose tolerance status in non-diabetic Korean subjects. Methods: We analyzed the data from 1,482 subjects without diabetes mellitus in whom a 75-g oral glucose tolerance test (OGTT) was performed due to suspected abnormal glucose tolerance. We obtained an HbA1c cutoff point for predicting diabetes using Receiver Operating Characteristic (ROC) curve analysis. Results: A cut-off point of 5.95% HbA1c yielded sensitivity of 60.8% and specificity of 85.6%, respectively, for predicting diabetes. There was a difference in HbA1c cut-off value between men and women, 5.85% and 6.05%, respectively. Conclusion: To use the cut-off point of 5.95% HbA1c for predicting undiagnosed diabetes in Koreans may be reliable. However, studies of different ethnic groups have reported disparate HbA1c cut-off points. Thus, ethnicity, age, gender, and population prevalence of diabetes are important factors to consider in using elevated HbA1c value as a tool to diagnose diabetes.


Background: Glycated hemoglobin (HbA1c) levels represent a 2~3 month average of blood glucose concentration. The use of HbA1c as a diagnostic tool for diabetes is gaining interest. Therefore, we determined the cutoff point of HbA1c for predicting abnormal glucose tolerance status in non-diabetic Korean subjects. Methods: We analyzed the data from 1,482 subjects without diabetes mellitus in whom a 75-g oral glucose tolerance test (OGTT) was performed due to suspected abnormal glucose tolerance. We obtained an HbA1c cutoff point for predicting diabetes using Receiver Operating Characteristic (ROC) curve analysis. Results: A cut-off point of 5.95% HbA1c yielded sensitivity of 60.8% and specificity of 85.6%, respectively, for predicting diabetes. There was a difference in HbA1c cut-off value between men and women, 5.85% and 6.05%, respectively. Conclusion: To use the cut-off point of 5.95% HbA1c for predicting undiagnosed diabetes in Koreans may be reliable. However, studies of different ethnic groups have reported disparate HbA1c cut-off points. Thus, ethnicity, age, gender, and population prevalence of diabetes are important factors to consider in using elevated HbA1c value as a tool to diagnose diabetes.