Supplementary use of HbA1c as hyperglycemic criterion to detect metabolic syndrome

Background: Metabolic syndrome (MetS) refers to a cluster of cardiovascular risk factors including hyperglycemia, dyslipidemia, abdominal obesity and hypertension. An effective detection of MetS not only reflects the prediction risk of diabetes mellitus and cardiovascular diseases but also helps to plan for management strategy which could reduce the healthcare burden of the society. This study aimed to compare the use of hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) as the hyperglycemic component in MetS diagnosis. Methods: Waist circumference, blood pressure, blood triglyceride, high-density lipoprotein (HDL)-cholesterol, FPG, and HbA1c were examined in 120 Hong Kong Chinese adults with MetS and 120 without MetS. After reviewing the subject basal characteristics, 11 of them were found with undiagnosed diabetes (FPG ≧7.0 mmol/L) and were excluded for further analysis. Results: The most prevalent MetS components among the included subjects were elevated systolic blood pressure and central obesity. Significant correlation relationships existed between FPG and HbA1c in both subject pools diagnosed with and without MetS (p < 0.001). The diagnostic rate of MetS using HbA1c was compared to FPG by the receiver operating characteristics (ROC) analysis which suggested an area under curve of 0.807 (95% CI: 0.727 to 0.887). The agreement was 90.7% in MetS-positive group with increased FPG as one of the criterion co-existed with elevated HbA1c. If including HbA1c as an additional criterion to FPG in the MetS diagnosis, 30 more participants in MetS-negative group would be MetS-positive leading to an increase in detection rate. Furthermore, 47 subjects (38 from MetS-positive group and 9 from MetS-negative group) were found having HbA1c ≧6.5%, who would have been diagnosed with diabetes based on the diagnostic criteria implemented by the Expert Group in 2009. Conclusion: These findings suggest that HbA1c enhances the detection of hyperglycemia for the diagnosis of MetS.Department of Health Technology and Informatic

Factors influencing school connectedness: Chinese adolescents&apos; perspectives

Abstract This study explored the concept of school connectedness and the factors that may influence its development with a sample of Chinese adolescents. Six focus groups involving 52 high school students were conducted using a set of predetermined discussion topics. Results indicated that the students fully understood the notion of school connectedness and could identify a number of key influences affecting its development. These factors could be grouped under several domains including teacher care, peer relations, broader school relationships, school disciplinary policies and practices, activities within the school&apos;s guidance and counseling program, and opportunities for talent development. The students were also able to suggest practical strategies that schools might introduce to enhance and strengthen students&apos; acquisition of connectedness to school. The implications from the findings are discussed with particular reference to implementing comprehensive school guidance and counseling program in Hong Kong