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Correlations between A1c, fasting glucose, 2h postload glucose, and β-cell function in the Chinese population
Cuiliu Li1, Huijie Yang, Guoyu Tong
1Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University School of Medicine, Nanjing, 210008, China.
Acta Diabetologica
|March 6, 2014
Summary
Hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and 2h postload plasma glucose (2hPG) all correlate with declining beta-cell function. Combining HbA1c and FPG offers a sensitive method for assessing beta-cell function in the Chinese population.
Area of Science:
- Endocrinology
- Metabolic Health
- Diabetes Research
Background:
- Beta-cell dysfunction is central to type 2 diabetes pathogenesis.
- Accurate assessment of beta-cell function is crucial for early diagnosis and management.
- Existing markers like HbA1c and fasting plasma glucose (FPG) have limitations in reflecting dynamic glucose metabolism.
Purpose of the Study:
- To evaluate the association between hemoglobin A1c (HbA1c), FPG, and 2h postload plasma glucose (2hPG) with beta-cell function in a Chinese cohort.
- To compare the efficacy of HbA1c, FPG, and 2hPG in assessing beta-cell function.
- To identify optimal combinations of glucose markers for evaluating beta-cell function.
Main Methods:
- A cohort of 913 Chinese subjects underwent oral glucose tolerance testing (OGTT) and HbA1c measurement.
- Beta-cell function was assessed using indices like HOMA-β, InsAUC/GluAUC ratios, and disposition index (DI).
- Subjects were categorized based on OGTT criteria for isolated impaired fasting glucose (i-IFG) and isolated impaired glucose tolerance (i-IGT).
Main Results:
- All glucose markers (HbA1c, FPG, 2hPG) showed significant inverse correlations with beta-cell function indices (p < 0.01).
- Beta-cell function declined sharply when HbA1c exceeded 5.5%.
- FPG demonstrated stronger correlations with insulin secretion and disposition indices compared to HbA1c and 2hPG.
- The combination of i-IFG and HbA1c (5.7-6.4%) resulted in the most significant reduction in disposition indices.
Conclusions:
- HbA1c is a useful marker for identifying impaired beta-cell function, but OGTT provides a more comprehensive assessment.
- Fasting plasma glucose (FPG) is more strongly associated with early insulin secretion and beta-cell function than 2hPG.
- A combined approach using HbA1c and FPG offers a simple yet sensitive method for evaluating beta-cell function in the Chinese population.
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