Risk factors associated with high glycated hemoglobin levels (≥5.7%) in Korean adults with normal fasting glucose

Background: Early detection of high risk for Type 2 diabetes (T2DM) and early diagnosis of T2DM are fundamental for the prevention of diabetes and associated complications. Aim: To identify the major predictors of high glycated hemoglobin (HbA(1C)) levels in people with normal fasting glucose levels. Subjects and methods: This was a cross-sectional study involving 8035 adults aged >= 20 yr. Multivariate logistic regression analyses were performed to estimate the odds ratios (OR) of clinical risk factors for high HbA(1C) (>= 5.7%) in the subjects with normal fasting glucose levels (<100 mg/dl). Results: Except for fasting glucose levels, age, and total cholesterol levels were significantly associated with HbA(1C) levels. After adjustment for gender, fasting glucose, and behavioral factors, OR for high HbA(1C) levels for age (>= 40 yr old) and high total cholesterol levels (>= 200 mg/dl) were 2.27 (95% CI: 2.01-2.56) and 1.76 (95% CI: 1.56-1.97), respectively. Each OR was higher than that of metabolic syndrome (MS) (OR=1.59, 95% CI: 1.34-1.87). Coexistence of both factors had a higher OR (OR=2.40, 95% CI: 2.11-2.72) for high HbA(1C) levels when compared to each factor alone. Conclusions: HbA(1C) was significantly associated with fasting glucose, age, and total cholesterol levels. In subjects with normal fasting glucose levels, age of over 40 yr or high total cholesterol levels (>= 200 mg/dl) is more predictive of high HbA(1C) levels than MS. These findings suggest that both factors might be better predictors than MS for the screening of pre-diabetes or diabetes in clinical practice. (J. Endocrinol. Invest. 35: 730-734, 2012) (c) 2012, Editrice Kurtis