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Pitfalls in the use of HbA1c as a diagnostic test

Nature Reviews Endocrinology volume 7, page 1 (2011)Cite this article

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In their correspondence (A conundrum addressed: The prognostic value of HbA1c. Nat. Rev. Endocrinol. 7, doi:10.1038/nrendo.2010.126-c1), Selvin and Brancati raise four issues regarding my Perspectives article (Pitfalls in the use of HbA1c as a diagnostic test: the ethnic conundrum. Nat. Rev. Endocrinol. 6, 589–593 (2010))1 on the diagnostic use of HbA1c.

First, they question the clinical significance of genetic contribution to the variation in HbA1c levels. In addition to the paper by Snieder et al.,2 several reports document differential genetic influences on HbA1c and fasting glucose values that would make it clinically precarious to use HbA1c alone for the diagnosis of diabetes mellitus or prediabetes.3,4,5,6,7 Among patients with type 1 diabetes mellitus enrolled in the Diabetes Control and Complications Trial, genome-wide association studies identified a major locus (near SORCS1) that was associated with both HbA1c and glucose (P = 7 × 10−10 for the association with HbA1c, P = 2 × 10−5 for the association with mean glucose).3

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References

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  1. Division of Endocrinology, Diabetes & Metabolism, University of Tennessee Health Science Center, 920 Madison Avenue, Suite 300A, Memphis, 38163, TN, USA

    Samuel Dagogo-Jack

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  1. Samuel Dagogo-Jack
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Dagogo-Jack, S. Pitfalls in the use of HbA1c as a diagnostic test. Nat Rev Endocrinol 7, 1 (2011). https://doi.org/10.1038/nrendo.2010.126-c2

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