Improved Detection of Abnormal Glucose Tolerance in Africans: The Value of Combining Hemoglobin A1c With Glycated Albumin
| Autor: | Stephanie T. Chung, Thomas Hormenu, Elyssa M. Shoup, Joon Ha, David B. Sacks, Anne E. Sumner, Nana H. Osei-Tutu, Arsene F. Hobabagabo, Christopher Dubose, Arthur Sherman, Lilian Mabundo |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percentile Endocrinology Diabetes and Metabolism Population 030209 endocrinology & metabolism 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Glycated albumin Diabetes mellitus Internal medicine Internal Medicine medicine 030212 general & internal medicine education Glycemic Advanced and Specialized Nursing education.field_of_study Reproducibility business.industry medicine.disease Endocrinology Fructosamine chemistry Hemoglobin business |
| Zdroj: | Diabetes Care. 43:2607-2613 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc20-1119 |
| Popis: | OBJECTIVE In African-born Blacks living in America, we determined by BMI category 1) prevalence of abnormal glucose tolerance (Abnl-GT) and 2) diagnostic value and reproducibility of hemoglobin A1c (HbA1c), fructosamine, and glycated albumin (GA). RESEARCH DESIGN AND METHODS Participants (n = 416; male, 66%; BMI 27.7 ± 4.5 kg/m2 [mean ± SD]) had an oral glucose tolerance test with HbA1c, GA, and fructosamine assayed. These glycemic markers were repeated 11 ± 7 days later. Abnl-GT diagnosis required 0 h ≥5.6 mmol/L (≥100 mg/dL) and/or 2 h ≥7.8 mmol/L (≥140 mg/dL). Thresholds for HbA1c, GA, and fructosamine were the values at the 75th percentile for the population (39 mmol/mol [5.7%], 14.2%, and 234 μmol/L, respectively). RESULTS Abnl-GT prevalence in the nonobese was 34% versus 42% in the obese (P = 0.124). Reproducibility was excellent for HbA1c and GA (both κ ≥ 0.8), but moderate for fructosamine (κ = 0.6). Focusing on HbA1c and GA in the nonobese, we found as single tests the sensitivities of HbA1c and GA were 36% versus 37% (P = 0.529). Combining HbA1c and GA, sensitivity increased to 58% because GA identified 37% of Africans with Abnl-GT not detected by HbA1c (P value for both tests vs. HbA1c alone was CONCLUSIONS Adding GA to HbA1c improves detection of Abnl-GT in nonobese Africans. |
| Databáze: | OpenAIRE |
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