Glycated albumin in diabetes mellitus: a meta-analysis of diagnostic test accuracy
Fernando Chimela Chume, Priscila Aparecida Corrêa Freitas, Luisa Gazzi Schiavenin, Ana Laura Pimentel, Joíza Lins Camargo
Abstract
OBJECTIVES: . We conducted a systematic review and meta-analysis to determine the overall diagnostic accuracy of GA for the diagnosis of diabetes. CONTENT: We searched for articles of GA diabetes diagnostic accuracy that were published up to August 2021. Studies were selected if reported an oral glucose tolerance test as a reference test, measured GA levels by enzymatic methods, and had data necessary for 2 × 2 contingency tables. A bivariate model was used to calculate the pooled estimates. SUMMARY: This meta-analysis included nine studies, totaling 10,007 individuals. Of those, 3,106 had diabetes. The studies showed substantial heterogeneity caused by a non-threshold effect and reported different GA optimal cut-offs for diagnosing diabetes. The pooled diagnostic odds ratio (DOR) was 15.93 and the area under the curve (AUC) was 0.844, indicating a good level of overall accuracy for the diagnosis of diabetes. The effect of the GA threshold on diagnostic accuracy was reported at 15.0% and 17.1%. The optimal cut-off for diagnosing diabetes with GA was estimated as 17.1% with a pooled sensitivity of 55.1% (95% CI 36.7%-72.2%) and specificity of 94.4% (95% CI 85.3%-97.9%). OUTLOOK: GA has good diabetes diagnostic accuracy. A GA threshold of 17.1% may be considered optimal for diagnosing diabetes in previously undiagnosed individuals.