Improved Detection of Abnormal Glucose Tolerance in Africans: The Value of Combining Hemoglobin A1c With Glycated Albumin

• DOI: 10.2337/dc20-1119
• Publication Date: 2020-08-15T01:55:21Z
• Authors: Arsene F. Hobabagabo; Nana H. Osei-Tutu; Thomas Hormenu; Elyssa M. Shoup; Christopher W. Du...; Lilian S. Mabundo; Joon Ha; Arthur Sherman; Stephanie T. Chung; David B. Sacks; Anne E. Sumner
• Keywords: Glycated hemoglobin; Value (mathematics)

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 reproducibility hemoglobin A1c (HbA1c), fructosamine, glycated albumin (GA). RESEARCH DESIGN AND METHODS Participants (n = 416; male, 66%; 27.7 ± 4.5 kg/m2 [mean SD]) had an oral test with HbA1c, GA, 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 ≥7.8 (≥140 mg/dL). Thresholds for the values at 75th percentile population (39 mmol/mol [5.7%], 14.2%, 234 μmol/L, respectively). RESULTS nonobese was 34% versus 42% obese (P 0.124). Reproducibility excellent HbA1c GA (both κ ≥ 0.8), but moderate (κ 0.6). Focusing on nonobese, found as single tests sensitivities 36% 37% 0.529). Combining sensitivity increased to 58% because identified Africans not detected both vs. alone <0.001). For obese, combined 60%, 27%, 67%, respectively. Combined did differ from 0.25) only 10% HbA1c. CONCLUSIONS Adding improves detection Africans.