Key result
Replacing fasting plasma glucose with HbA1c >5.7% in the metabolic syndrome definition improved prediction of vascular damage (diagnostic ORs: 6.94 for PWv, 1.34 for IMT, and 1.90 for ACR).
Why the study?
To assess the suitability of replacing conventional markers for insulin resistance and dysglycemia with HbA1c in quantitative and qualitative metabolic syndrome definition criteria.
Does replacing fasting plasma glucose with HbA1c > 5.7% in the metabolic syndrome definition improve the prediction of vascular damage in adults?
Observational
Does replacing fasting plasma glucose with HbA1c > 5.7% in the metabolic syndrome definition improve the prediction of vascular damage in adults?
Effect estimate: Diagnostic ORs: 6.94, 1.34, and 1.90
Replacing fasting plasma glucose with HbA1c > 5.7% in the metabolic syndrome definition improves the prediction of subclinical vascular damage.
May support HbA1c substitution in metabolic syndrome criteria for vascular assessment; hypothesis-generating, needs prospective validation.
(1) Background: To assess the suitability of replacing conventional markers used for insulin resistance and dysglycemia by HbA1c in both the quantitative and qualitative metabolic syndrome (MetS) definition criteria; (2) Methods: Confirmatory factorial analysis was used to compare three quantitative definitions of MetS that consisted of many single-factor models, one of which included HbA1c as the dysglycemia indicator. After that, the model with the better goodness-of-fit was selected. Furthermore, a new MetS qualitative definition was proposed by replacing fasting plasma glucose with HbA1c > 5.7% in the International Diabetes Federation (IDF) definition. The clinical performance of these two MetS criteria (IDF and IDF-modified including HbA1c as the dysglycemia indicator) to predict vascular damage (pulse wave velocity [PWv], intima media thickness [IMT] and albumin-to-creatinine ratio [ACR]) was estimated; (3) Results: The single-factor model including HbA1c showed the better goodness-of-fit (χ2 = 2.45, df = 2, p = 0.293, CFI = 0.999, SRMR = 0.010). Additionally, the IDF-modified criteria gained in clinical performance to predict vascular damage (diagnostic Odds Ratio: 6.94, 1.34 and 1.90) for pulse wave velocity (PWv), intima media thickness (IMT) and albumin-to-creatinine ratio (ACR), respectively; and (4) Conclusions: These data suggest that HbA1c could be considered as a useful component to be included in the MetS definition.
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Cavero‐Redondo et al. (2019) conducted an observational in Metabolic Syndrome. HbA1c > 5.7% as dysglycemia indicator in MetS definition vs. Fasting plasma glucose (standard IDF definition) was evaluated on Prediction of vascular damage (pulse wave velocity, intima media thickness, and albumin-to-creatinine ratio) (Diagnostic ORs: 6.94, 1.34, and 1.90). Replacing fasting plasma glucose with HbA1c >5.7% in the metabolic syndrome definition improved prediction of vascular damage (diagnostic ORs: 6.94 for PWv, 1.34 for IMT, and 1.90 for ACR).
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