Comparison of ADA and WHO Criteria in Detecting Pattern of Glucose Disorders in a Population-Based Study: Tehran Lipid and Glucose Study

N Saadat; H Emami; P Salehi; F Azizi

International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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Comparison of ADA and WHO Criteria in Detecting Pattern of Glucose Disorders in a Population-Based Study: Tehran Lipid and Glucose Study

Author(s):

N Saadat¹,

H Emami¹,

P Salehi¹,

F Azizi^2,*

1Endocrine Research Center, Shaheed Beheshti University of Medical Sciences, IR.Iran

2Endocrine Research Center, Shaheed Beheshti University of Medical Sciences, Azizi@erc.ac.ir, IR.Iran

International Journal of Endocrinology and Metabolism:Vol. 4, issue 4; 158-164

Article type:Research Article

Received:Jun 01, 2005

Accepted:Nov 01, 2005

How to Cite:N SaadatH EmamiP SalehiF AziziComparison of ADA and WHO Criteria in Detecting Pattern of Glucose Disorders in a Population-Based Study: Tehran Lipid and Glucose Study.Int J Endocrinol Metab.4(4):158-164.

Abstract

Many studies have been performed to compare WHO and ADA criteria for detection of diabetic patients. This study aims to compare these two criteria in a community-based epidemiological survey in an urban population of Tehran, Iran. Materials and Methods: Subjects were chosen from among 15005 urban individuals, 3 years old and over, selected by cluster random sampling in the cross-sectional phase of a longitudinal study conducted in the east of Tehran; there were 3870 men and 5359 women aged 20 years and over. Those with known diabetes were excluded. Blood samples were taken after 12-14 hours overnight fast and 2 hours post 75gr glucose taken orally. Prevalence of glucose tolerance categories and the level of agreement (? statistic) were obtained using WHO and ADA criteria. Results: Based on WHO criteria 6.0% (0.95 CI, 5.5-6.5) had type-2 diabetes and 13.0% (12.3-13.7) had IGT (Impaired glucose tolerance). Using ADA, 3.3% (2.9-3.7) had type-2 diabetes and 4.8% (4.4-5.2) had IFG (Impaired fasting glucose); p<0.05 and <0.001 for diabetes and IGT, respectively and 7355 (84%) had concordance with both criteria. Among 7105 normal subjects classified according to WHO criteria, 153 (2.2%) had IFG or diabetes by ADA, whereas from 8068 normal subjects according to ADA criteria, 1116 (13.8%) had IGT or diabetes based on WHO criteria. The level of agreement (? statistic) between the two criteria was 35% (p<0.001). Sensitivity and specificity of ADA criteria were 45.5 and 100%, respectively, considering WHO as the gold standard. Conclusion: Our data shows a low level of agreement between WHO and ADA diagnostic criteria for detection of diabetes. Patients with unknown diabetes, glucose disorders are detected more frequently using WHO criteria.

Keywords

Diabetes mellitus

Impaired glucose tolerance

Impaired fasting glucose

WHO criteria

ADA criteria

Tehran Lipid and Glucose Study

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