فهرست نشریات علمی دسترسی آزاد ایران

The use of glycemic thresholds for diabetes diagnosis is controversial. However, noinformation is available regardingglycemic and glycated hemoglobin (HbA1c) thresholds for detecting diabetic retinopathy (DR) in the Iranian population.Objectives: Themainpurpose of the current investigationwasto examine the association of fasting plasma glucose (FPG)andHbA1clevels with diabetic retinopathy (DR), and to determine the relevant cut-off levels in an Iranian population.Patients and Methods: This cross-sectional, population-based study was performed during 2012-2013 in Urmia, the capital of WestAzerbaijan province, Iran. The subjects were 3,010 Iranians aged 40-81 years. The FPG levels were determined using the glucose oxidasemethod whereas, the HbA1c values were measured using a standardized assay by high performance liquid chromatography.DR was evaluated by an examination of the fundus photograph of each eye. The photographs were graded according to the internationalclinical diabetic retinopathy disease severity scale by photograph graders who were masked to the clinical information.Results: Of the subjects, 59 had DR. The prevalence of DR increased steeply between the ninth and the tenth deciles for both variables.The ROC curve analysis showed overall glycemic thresholds for DR of 6.5 mmol/L (117 mg/dL) for FPG and 6.2% (44 mmol/mol)for HbA1c. The sensitivities and specificities were 78.0% and 87.1% for FPG and 89.8% and 89.5% for HbA1c, respectively. The areasunder the ROC curves indicated that HbA1c was a stronger discriminator of retinopathy: the area under curve was 0.880 for FPG and0.946 for HbA1c P < 0.001). However, the thresholds for detecting DR for the two measures showed no significant differences afterexcluding individuals receiving anti-hyperglycemic medication.Conclusions: These findings suggest that the HbA1c and FPG thresholds for detecting diabetes in the Iranian population are lowerthan the current diagnostic criteria.