HIV infection and anaemia do not affect HbA 1c for the detection of diabetes in black South Africans: Evidence from the Durban Diabetes Study

Autor: Elizabeth H. Young, Ayesha A. Motala, Thomas R. Hird, Brian O’Leary, Tonya M. Esterhuizen, Fraser J. Pirie, Manjinder S Sandhu, Uttara Partap, Pravi Moodley, Mark I. McCarthy
Rok vydání: 2021
Předmět:
Zdroj: Diabetic Medicine. 38
ISSN: 1464-5491
0742-3071
DOI: 10.1111/dme.14605
Popis: OBJECTIVE South Africa has a high burden of HIV infection and anaemia. These conditions may cause HbA1c to over- or underestimate glycaemia; however, this has not been comprehensively investigated in African populations. We assessed the association of anaemia, HIV infection and antiretroviral therapy (ART) with HbA1c , and implications for the detection and diagnosis of diabetes, in a black South African population. RESEARCH DESIGN AND METHODS In this population-based cross-sectional study in eThekwini municipality (Durban), South Africa, we assessed HbA1c and conducted oral glucose tolerance tests (OGTTs), HIV diagnostic tests and full blood count measurements among 1067 participants without a history of diabetes diagnosis. Linear regression was used to examine differences in HbA1c by anaemia (comparator: no anaemia), or HIV and ART (comparator: no HIV) status. HbA1c -based diabetes prevalence was compared with OGTT-based prevalence among individuals with anaemia and with untreated and ART-treated HIV. RESULTS In adjusted analyses, normocytic and microcytic anaemia were associated with higher HbA1c compared with no anaemia, whereas macrocytic anaemia and ART-treated HIV were associated with lower HbA1c compared with no anaemia and no HIV, respectively. However, magnitudes of association were small (range: β = -3.4 mmol/mol or -0.31%, p
Databáze: OpenAIRE
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