Biomarker Assessment of Dysglycemia Diagnosis: A Comparative Study

Background: Dysglycemia, a spectrum of glucose metabolism disorders, requires timely and accurate diagnosis to prevent complications like cardiovascular disease and diabetes progression. Biomarkers such as fasting plasma glucose, HbA1c, and oral glucose tolerance tests are widely used, offering distinct diagnostic advantages. This study aimed to assess and compare the effectiveness of various biomarkers in diagnosing dysglycemia. Methods: This cross-sectional study was conducted at the Department of Biochemistry and Molecular Biology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March to 2019 to February 2020. A total of 1,165 individuals attending the Endocrinology Outpatient Department at BSMMU for dysglycemia screening, including prediabetes and diabetes, were enrolled using a non-probability sampling method. Data analysis was carried out using SPSS version 23.0. Results: In this study, diabetes prevalence was observed as 21.2% using 2hPG, 15.9% with FPG, and 23.3% through HbA1C, while prediabetes rates were 28.4% for FPG, 24.5% for 2hPG, and 37.8% for HbA1C. Although no significant difference was found between 2hPG and HbA1C, FPG tended to underestimate diabetes. The concordance among diagnostic tools was 12.4%, with the highest detection rate (25.6%) achieved using 2hPG and HbA1C. Age influenced diagnostic outcomes, and good agreement was noted among FPG, 2hPG, and HbA1C. FPG demonstrated lower sensitivity but comparable specificity to HbA1C. Conclusion: The study reveals that HbA1C has the highest diabetes detection rate, followed by 2hPG, while FPG underestimates diabetes. Combining 2hPG and HbA1C offers the most accurate diagnosis, with age-influencing outcomes and FPG showing lower sensitivity but similar specificity to HbA1C.