Cut-off value of glycated hemoglobin A1c for detecting diabetic retinopathy in the Chinese population

BACKGROUND Glycated hemoglobin A1c(HbA1c)is considered the most suitable for diabetes mellitus diagnosis due to its accuracy and convenience.However,the effect of HbA1c on diabetic retinopathy(DR)in the Han and Korean populations in Jilin,China,remains inconclusive.AIM To determine the best cut-off of HbA1c for diagnosing DR among the Chinese.METHODS This cross-sectional study included 1933 participants from the Yanbian area of Jilin Province,China.Trained investigators employed a questionnaire-based survey,physical examination,laboratory tests,and fundus photography for the investigation.The best cut-off value for HbA1c was established via the receiver operating characteristic curve.The factors associated with HbA1c-associated risk factors were determined via linear regression.RESULTS The analysis included 887 eligible Chinese Han and Korean participants,591 of whom were assigned randomly to the training set and 296 to the validation set.The prevalence of DR was 3.27% in the total population.HbA1c of 6.2% was the best cut-off value in the training set,while it was 5.9% in the validation set.In both Chinese Han and Korean populations,an HbA1c level of 6.2% was the best cut-off value.The optimal cut-off values of fasting blood glucose(FBG)≥7 mmol/L and<7 mmol/L were 8.1% and 6.2% respectively in Han populations,while those in Korean populations were 6.9%and 5.3%,respectively.Age,body mass index,and FBG were determined as the risk factors impacting HbA1c levels.CONCLUSION HbA1c may serve as a useful diagnostic indicator for DR.An HbA1c level of 6.2% may be an appropriate cut-off value for DR detection in the Chinese population.

Acetylsalicylic Acid Administered in Patients with Type 2 Diabetes Mellitus and Its Effect on the Antioxidant Enzyme System

Type 2 diabetes mellitus and its complications are associated with oxidative stress and the depletion of antioxidant defenses. The influence of acetylsalicylic acid on reversing the decrease in antioxidants, insulin resistance, glucose homeostasis, and inflammatory cascade can help prevent diabetes complications. Purpose: The aim of the study was to evaluate the effect of acetylsalicylic acid on the antioxidant enzymatic system in patients with diabetes. Methods: A randomized, double-blind, placebo-controlled clinical trial was carried out in 21 patients of both sexes with Type 2 diabetes for less than five years at the time of diagnosis, without pharmacological treatment, and randomly selected. Acetylsalicylic acid (300 mg) was administered orally for three months to the study group (n = 11) compared to the placebo control group (n = 10). Before and after the intervention, anthropometric and metabolic measurements were taken, fasting plasma glucose, glycated hemoglobin A1c, lipid profile panel, glutathione peroxidase, superoxide dismutase, catalase, and antioxidant capacity/activity were determined;values are presented as mean ± standard deviation. Intra- and intergroup differences were tested by Wilcoxon signed rank and Mann-Whitney U test, respectively;p-value ≤ 0.05 was considered statistically significant. Results: The acetylsalicylic acid group showed a decrease in weight (85.6 ± 19.3 vs. 84.1 ± 19.0 kg p = 0.01), cholesterol (205.9 ± 16.6 vs. 186.0 ± 23.2 mg/dL p = 0.02), and glycated hemoglobin A1c (7.8% ± 0.9% vs. 7.0% ± 0.7% p = 0.02). The placebo group exhibited reduction in weight (76.1 ± 14.9 vs. 74.9 ± 15.0 kg p = 0.04), glycated hemoglobin A1c (6.9% ± 0.6% vs. 6.2% ± 0.4% p = 0.004), and total antioxidant capacity (4.1 ± 0.5 vs. 4.8 ± 0.3 mmol/L p = 0.002). Conclusion: The administration of acetylsalicylic acid did not modify the antioxidant enzyme system.