Journal Information
Journal ID (publisher-id): BM
Journal ID (nlm-ta): Biochem Med (Zagreb)
Title: Biochemia Medica
Abbreviated Title: Biochem. Med. (Zagreb)
ISSN (print): 1330-0962
ISSN (electronic): 1846-7482
Publisher: Croatian Society of Medical Biochemistry and Laboratory Medicine
Article Information
Copyright statement: ©Croatian Society of Medical Biochemistry and Laboratory Medicine.
Copyright: 2021, Croatian Society of Medical Biochemistry
License (open-access):
This is an Open Access article distributed under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date received: 07 September 2021
Date accepted: 11 November 2021
Publication date (electronic): 15 December 2021
Publication date (print): 15 February 2022
Volume: 32
Issue: 1
Electronic Location Identifier: 010903
Publisher ID: bm-32-1-010903
DOI: 10.11613/BM.2022.010903
Haemoglobin A1c-based screening for prediabetes and diabetes mellitus: a multi-center study in Croatian adult population
Katarina Kajić[4]
Nena Peran[5]
Lada Surjan[5]
Anamarija Đuras[6]
Valentina Cesar Kocijan[6]
Nada Bilopavlović[7]
Fran Smaić[8]
Ivanka Ostroški[6]
Leida Tandara[7]
Milena Krnjaić-Tadijanović[8]
Ivan Gornik[9]
Daniela Marasović Krstulović[12]
Blaženka Miškić[13]
Dario Rahelić[14]
[1] Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia
[2] Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
[3] Department for Clinical Chemistry, University Clinical Hospital Sestre milosrdnice, Zagreb, Croatia
[4] Laboratory for Medical Biochemistry, General Hospital Bjelovar, Bjelovar, Croatia
[5] Department of Laboratory Diagnostics, General Hospital of Šibenik-Knin County, Šibenik, Croatia
[6] Laboratory for Medical Biochemistry, General Hospital Varaždin, Varaždin, Croatia
[7] Department of Medical Laboratory Diagnostics, University Hospital Center Split, Split, Croatia
[8] Department of Laboratory Diagnostics, General Hospital ‘Dr Josip Benčević’, Slavonski Brod, Croatia
[9] Department of Emergency Medicine, University Hospital Center Zagreb, Zagreb, Croatia
[10] Emergency Department, University Clinical Hospital Sestre milosrdnice, Zagreb, Croatia
[11] School of Dental Medicine, University of Zagreb, Zagreb, Croatia
[12] Internal Clinic, University Hospital Center Split, Split, Croatia
[13] Department for Internal Medicine, General Hospital ‘Dr Josip Benčević’, Slavonski Brod, Croatia
[14] Department of Diabetes and Endocrinology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
Author notes:
[*] Corresponding author: ivana.lapic@hotmail.com
Introduction
Based on the hypothesis that there is a substantial rate of adults with prediabetes and undiagnosed diabetes mellitus (DM), our aim was to perform haemoglobin A1c (HbA1c)-based screening in a cohort of Croatian adults and estimate the prevalence of prediabetes and undiagnosed DM according to American Diabetes Association criteria.
Materials and methods
This multi-center, cross-sectional study performed in six Croatian hospitals included 5527 patients aged 40 to 70 years admitted to the Emergency Department or undergoing a primary care check-up. Haemoglobin A1c was measured from leftover whole blood samples using the enzymatic method on either Alinity c or Architect c-series analyser (Abbott Laboratories, Chicago, USA). Haemoglobin A1c between 39-47 mmol/mol was classified as prediabetes, while ≥ 48 mmol/mol as undiagnosed DM.
Results
After exclusion of 435 patients with known DM, the final cohort included 5092 patients (median age 57; 56% males). A total of 882 (17.3%) patients had HbA1c values between 39 and 47 mmol/mol. There were 214 (4.2%) patients with HbA1c ≥ 48 mmol/mol. Prediabetes prevalence ranged from 14.2% to 20.5%, while undiagnosed DM from 3.3% to 7.3%, with statistically significant differences among settings (P < 0.001). Age-stratified analysis showed that prediabetes and undiagnosed DM prevalence increase with age (P < 0.001), being 25.4% and 5.8%, respectively, in patients aged 60 to 70 years.
Keywords: haemoglobin A1c; prediabetes; diabetes mellitus; prevalence
