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Open AccessArticle

Metabolic Syndrome Including Glycated Hemoglobin A1c in Adults: Is It Time to Change?

1
Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain
2
Universidad Politécnica y Artísitica del Paraguay, 001518 Asunción, Paraguay
3
Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, 3460000 Talca, Chile
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Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain
5
Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37003 Salamanca, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2090; https://doi.org/10.3390/jcm8122090
Received: 17 October 2019 / Revised: 21 November 2019 / Accepted: 23 November 2019 / Published: 1 December 2019
(This article belongs to the Section Endocrinology & Metabolism)
(1) Background: To assess the suitability of replacing conventional markers used for insulin resistance and dysglycemia by HbA1c in both the quantitative and qualitative metabolic syndrome (MetS) definition criteria; (2) Methods: Confirmatory factorial analysis was used to compare three quantitative definitions of MetS that consisted of many single-factor models, one of which included HbA1c as the dysglycemia indicator. After that, the model with the better goodness-of-fit was selected. Furthermore, a new MetS qualitative definition was proposed by replacing fasting plasma glucose with HbA1c > 5.7% in the International Diabetes Federation (IDF) definition. The clinical performance of these two MetS criteria (IDF and IDF-modified including HbA1c as the dysglycemia indicator) to predict vascular damage (pulse wave velocity [PWv], intima media thickness [IMT] and albumin-to-creatinine ratio [ACR]) was estimated; (3) Results: The single-factor model including HbA1c showed the better goodness-of-fit (χ2 = 2.45, df = 2, p = 0.293, CFI = 0.999, SRMR = 0.010). Additionally, the IDF-modified criteria gained in clinical performance to predict vascular damage (diagnostic Odds Ratio: 6.94, 1.34 and 1.90) for pulse wave velocity (PWv), intima media thickness (IMT) and albumin-to-creatinine ratio (ACR), respectively; and (4) Conclusions: These data suggest that HbA1c could be considered as a useful component to be included in the MetS definition. View Full-Text
Keywords: metabolic syndrome; vascular health; HbA1c metabolic syndrome; vascular health; HbA1c
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Cavero-Redondo, I.; Martínez-Vizcaíno, V.; Álvarez-Bueno, C.; Agudo-Conde, C.; Lugones-Sánchez, C.; García-Ortiz, L. Metabolic Syndrome Including Glycated Hemoglobin A1c in Adults: Is It Time to Change? J. Clin. Med. 2019, 8, 2090.

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