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Open AccessArticle

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

Universidad de Castilla-La Mancha, Health and Social Research Center, 16071 Cuenca, Spain
Universidad Politécnica y Artísitica del Paraguay, 001518 Asunción, Paraguay
Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, 3460000 Talca, Chile
Institute of Biomedical Research of Salamanca (IBSAL), Primary Care Research Unit of Salamanca (APISAL), Health Service of Castilla y León (SACyL), 37003 Salamanca, Spain
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;
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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