DISTRIBUSI DAN FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KADAR HEMOGLOBIN A1C (HbA1c) PADA SUBJEK DEWASA INDONESIA
HbA1c is a parameter that may be used in predicting and diagnosing diabetes. Since diabetes is predicted to increase in Indonesia, it is necessary to understand the distribution and associated factors of HbA1c in the general Indonesian population. However, those data are still limited. This study aims to determine the distribution of HbA1c and its associated factors in Indonesian adults. We conducted a cross-sectional study analyzing data from Indonesia Family Life Survey (IFLS) 2014-2015. HbA1c was analyzed using dried blood spot (DBS) specimen with Bio-Rad D10 HPLC. We performed Student’s t test and ANOVA to show the results of the bivariate analyses and multiple linear regression to determine the association between variables. The study included 4.101 subjects (20-59 years) without diabetes and provided an overview of the distribution of HbA1c levels based on socio-demographic factors and smoking behavior described in percentiles. The mean of HbA1c was 5.35% with a standard error of 0.01. The threshold value of HbA1c for prediabetes (5.7%) corresponded approximately to the 75th percentile. Although there were differences in HbA1c distribution, socio-demographic factors such as education levels, employment, and settlement region as well as smoking were not independently associated with HbA1c levels in Indonesian adults. Furthermore, age and sex were associated with HbA1c.
Shaw JE, Sicree RA, Zimmet PZ. Diabetes Atlas : Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87(1):4–14.
Balitbang Kemenkes RI. Riset Kesehatan Dasar. Jakarta: Kementerian Kesehatan RI; 2013.
Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2013;103(2):137–49.
Fiorentino T V., Hribal ML, Perticone M, Andreozzi F, Sciacqua A, Perticone F, et al. Unfavorable inflammatory profile in adults at risk of type 2 diabetes identified by hemoglobin A1c levels according to the American Diabetes Association criteria. Acta Diabetol. 2014;52(2):349–56.
Farmer A. Monitoring Diabetes. In: Holt RIG, Cockram CS, Flyvbjerg A, Goldstein BJ, editors. Textbook of Diabetes. 5th ed. Oxford: Wiley Blackwell; 2017. p. 375–6.
Franz MJ, Evert AB. Medical Nutrition Therapy for Diabetes Mellitus and Hypoglycemia of Nondiabetic Origin. In: Mahan LK, Raymond JL, editors. Krause’s Food & The Nutrition Care Process. 14th ed. Missouri: Elsevier; 2017. p. 591.
ADA. (2) Classification and diagnosis of diabetes. Diabetes Care. 2015;38 Suppl:S8–16.
WHO. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus : Abbreviated Report of a WHO Consultation. WHO/NMH/CH. Jenewa: World Health Organization; 2011.
Gerber SM, Stickle DF, Ahmed I, Jabbour SA. Glycated hemoglobin, serum proteins, and other markers as tools for monitoring. In: DeFronzo RA, Ferrannini E, Zimmet P, K. George M. M. Alberti, editors. International Textbook of Diabetes Mellitus. 4th ed. Oxford: Wiley Blackwell; 2015. p. 853–5.
ADA. Standards of Medical Care in Diabetesd-2014. Diabetes Care. 2014;37 Suppl 1:S14–80.
Kim CH, Kim HK, Kim EH, Bae SJ, Choe J, Park JY. Risk of progression to diabetes from prediabetes defined by HbA1c or fasting plasma glucose criteria in Koreans. Diabetes Res Clin Pract. 2016;118:105–11.
Zhang X, Gregg EW, Williamson DF, Barker LE, Thomas W, Bullard KMK, et al. A1C level and future risk of diabetes: A systematic review. Diabetes Care. 2010;33(7):1665–73.
Vijayakumar P, Nelson RG, Hanson RL, Knowler WC, Sinha M. HbA1c and the prediction of type 2 diabetes in children and adults. Diabetes Care. 2017;40(1):16–21.
Fizelova M, Stančáková A, Lorenzo C, Haffner SM, Cederberg H, Kuusisto J, et al. Glycated hemoglobin levels are mostly dependent on nonglycemic parameters in 9398 Finnish men without diabetes. J Clin Endocrinol Metab. 2015;100(5):1989–96.
Gesuita R, Skrami E, Bonfanti R, Cipriano P, Ferrito L, Frongia P, et al. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey. Pediatr Diabetes. 2017;18(3):241–8.
Bijlsma-Rutte A, Rutters F, Elders PJM, Bot SDM, Nijpels G. Socio-economic status and HbA1c in type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2018;34(6):e3008.
Grintsova O, Maier W, Mielck A. Inequalities in health care among patients with type 2 diabetes by individual socio-economic status ( SES ) and regional deprivation : a systematic literature review. Int J Equity Health. 2014;13:43.
Aliarzadeh B, Greiver M, Moineddin R, Meaney C, White D, Moazzam A, et al. Association between socio-economic status and hemoglobin A1c levels in a Canadian primary care adult population without diabetes. BMC Fam Pract. 2014;15:7.
Sakane N, Sato J, Tsushita K, Tsujii S, Kotani K, Tominaga M, et al. Determinants of Glycated Hemoglobin in Subjects With Impaired Glucose Tolerance : Subanalysis of the Japan Diabetes Prevention Program. J Clin Med Res. 2017;9(4):360–5.
Dubowitz N, Xue W, Long Q, Ownby JG, Olson DE, Barb D, et al. Aging is associated with increased HbA 1c levels, independently of glucose levels and insulin resistance, and also with decreased HbA 1c diagnostic specificity. Diabet Med. 2014;31(8):927–35.
Hong JW, Ku CR, Noh JH, Ko KS, Rhee BD, Kim DJ. Association between self-reported smoking and hemoglobin A1c in a Korean population without diabetes: The 2011-2012 Korean national health and nutrition examination survey. PLoS One. 2015;10(5):e0126746.
Strauss J, Witoelar F, Sikoki B. The Fifth Wave of the Indonesia Family Life Survey (IFLS5): Overview and Field Report. WR-1143/1-NIA/NICHD; 2016.
Ostler MW, Porter JH, Buxton OM. Dried Blood Spot Collection of Health Biomarkers to Maximize Participation in Population Studies. J Vis Exp. 2014;83:e50973.
Herningtyas EH, Hu P, Edenfield M, Strauss J, Crimmins E, Witoelar F, et al. IFLS Wave 5 Dried Blood Spot Data User Guide. WR-1143/6-NIA/NICHD; 2018.
Seo JY, Hwang S, Kim JH, Lee YA, Lee SY, Shin CH, et al. Distribution of glycated haemoglobin and its determinants in Korean youth and young adults: a nationwide population-based study. Sci Rep. 2018;8:1962.
Buffarini R, Restrepo-méndez MC, Silveira VM, Miranda JJ, Gonçalves HD, Oliveira IO, et al. Distribution of Glycated Haemoglobin According to Early-Life and Contemporary Characteristics in Adolescents and Adults without Diabetes : The 1982 and 1993 Pelotas Birth Cohorts. PLoS One. 2016;11(9):e0162614.
Davidson MB, Schriger DL. Effect of age and race/ethnicity on HbA1c levels in people without known diabetes mellitus: implications for the diagnosis of diabetes. Diabetes Res Clin Pr. 2010;87(3):415–412.
Gardiarini P, Sudargo T, Pramantara IDP. Kualitas Diet, Sosio-Demografi, Dan Dukungan Keluarga Hubungannya Dengan Pengendalian Gula Darah Pada Penderita Diabetes Melitus Tipe 2 Di Rumah Sakit Kanujoso Djatiwibowo (RSKD), Balikpapan. Gizi Indon. 2017;40(2):89–100.
Andrade CS, Ribeiro GS, Santos CAST, Neves RCS, Moreira ED. Factors associated with high levels of glycated haemoglobin in patients with type 1 diabetes: a multicentre study in Brazil. BMJ Open. 2017;7(12):e018094.
Osan JK, Punch JD, Watson M, Chan YX, Barrie P, Fegan PG, et al. Associations of demographic and behavioural factors with glycaemic control in young adults with type 1 diabetes mellitus. Intern Med J. 2016;46(3):332–8.
Clair C, Bitton A, Meigs JB, Rigotti NA. Relationships of Cotinine and Self-Reported Cigarette Smoking With Hemoglobin A1c in the U.S.: Results from the National Health and Nutrition Examination Survey, 1999-2008. Diabetes Care. 2011;34(10):2250–5.
Sari MI, Sari N, Darlan DM, Prasetya RJ. Cigarette Smoking and Hyperglycaemia in Diabetic Patients. Open Access Maced J Med Sci. 2018;6(4):634–7.
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