Influence of glycosylated hemoglobin on sight-threatening diabetic retinopathy: A population-based study
2011
Raman, Rajiv | Verma, Aditya | Pal, Swakshyar Saumya | Gupta, Aditi | Vaitheeswaran, K. | Sharma, Tarun
AIM: To evaluate the role of glycosylated hemoglobin (HbA1c) on the occurrence of sight-threatening diabetic retinopathy (STDR) in urban Chennai, Tamil Nadu, India. METHODS: A total of 5999 individuals were enumerated from the Chennai metropolis. Of these, 1414 subjects with diabetes were included for data analysis in the study. STDR or non-STDR groups were classified based on the fundus photographs. HbA1c was measured (Bio-Rad DiaSTAT™ HbA1c Reagent Kit) by the liquid chromatography technique. RESULTS: A statistically significant difference (p<0.05) was noted in the duration of diabetes, gender, body mass index, HbA1c, micro- and macro-albuminuria between both non-STDR and STDR groups as compared to the no-diabetic retinopathy (DR) group. On multivariate analysis, HbA1c (non-STDR: odd's ratio OR=1.23; 95% confidence interval CI=1.15–1.32; p<0.0001; STDR: OR=1.31 95% CI=1.14–1.52; p<0.0001) was found to be significantly associated with non-STDR and STDR when compared with the no-DR group. The Receiver Operating Characteristic analysis showed that the cut-off value of 8.0 had 75.6% sensitivity and 58.2% specificity with 64.9% maximum area under the curve. CONCLUSION: HbA1c value >8.0% was significantly related with STDR. In a screening programme, the cut-off value of HbA1c >8.0% provided a maximum yield of STDR.
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