Improved Detection of Abnormal Glucose Tolerance in Africans: The Value of Combining Hemoglobin A 1c With Glycated Albumin.

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  • Additional Information
    • Source:
      Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE
    • Publication Information:
      Publication: Alexandria Va : American Diabetes Association
      Original Publication: New York, American Diabetes Assn.
    • Subject Terms:
      Black People*/ethnology ; Glucose Intolerance*/diagnosis ; Glucose Intolerance*/epidemiology ; Glucose Intolerance*/ethnology ; Glycated Hemoglobin*/analysis ; Serum Albumin*/analysis; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Africa/ethnology ; Biomarkers/analysis ; Biomarkers/blood ; Black or African American ; Blood Glucose/analysis ; Fructosamine/analysis ; Fructosamine/blood ; Glucose Tolerance Test/methods ; Glucose Tolerance Test/standards ; Glycated Serum Albumin ; Glycation End Products, Advanced ; Obesity/blood ; Obesity/complications ; Obesity/diagnosis ; Obesity/ethnology ; Predictive Value of Tests ; Quality Improvement ; Reproducibility of Results ; United States/epidemiology
    • Abstract:
      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 A 1c (HbA 1c ), fructosamine, and glycated albumin (GA).
      Research Design and Methods: Participants ( n = 416; male, 66%; BMI 27.7 ± 4.5 kg/m 2 [mean ± SD]) had an oral glucose tolerance test with HbA 1c , 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 HbA 1c , 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 HbA 1c and GA (both κ ≥ 0.8), but moderate for fructosamine (κ = 0.6). Focusing on HbA 1c and GA in the nonobese, we found as single tests the sensitivities of HbA 1c and GA were 36% versus 37% ( P = 0.529). Combining HbA 1c and GA, sensitivity increased to 58% because GA identified 37% of Africans with Abnl-GT not detected by HbA 1c ( P value for both tests vs. HbA 1c alone was <0.001). For the obese, sensitivities for HbA 1c , GA, and the combined tests were 60%, 27%, and 67%, respectively. Combined test sensitivity did not differ from HbA 1c alone ( P = 0.25) because GA detected only 10% of obese Africans with Abnl-GT not detected by HbA 1c .
      Conclusions: Adding GA to HbA 1c improves detection of Abnl-GT in nonobese Africans.
      (© 2020 by the American Diabetes Association.)
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    • Molecular Sequence:
      ClinicalTrials.gov NCT00001853
      figshare 10.2337/figshare.12690023
    • Accession Number:
      0 (Biomarkers)
      0 (Blood Glucose)
      4429-04-3 (Fructosamine)
      0 (Glycated Hemoglobin)
      0 (Glycated Serum Albumin)
      0 (Glycation End Products, Advanced)
      0 (Serum Albumin)
    • Publication Date:
      Date Created: 20200818 Date Completed: 20210528 Latest Revision: 20240722
    • Publication Date:
      20240723
    • Accession Number:
      PMC7510044
    • Accession Number:
      10.2337/dc20-1119
    • Accession Number:
      32801129