Title | Racial differences in glycemic markers: a cross-sectional analysis of community-based data. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Selvin E, Steffes MW, Ballantyne CM, Hoogeveen RC, Coresh J, Brancati FL |
Journal | Ann Intern Med |
Volume | 154 |
Issue | 5 |
Pagination | 303-9 |
Date Published | 2011 Mar 01 |
ISSN | 1539-3704 |
Keywords | Aged, Blacks, Blood Glucose, Cross-Sectional Studies, Deoxyglucose, Diabetes Mellitus, Erythrocytes, Female, Fructosamine, Glycated Hemoglobin A, Humans, Male, Whites |
Abstract | BACKGROUND: Although differences between black and white persons in hemoglobin A(1c) (HbA(1c)) values are well established, recent studies suggest that this might not reflect differences in glycemia. OBJECTIVE: To investigate racial disparities in glycemic markers, including those that reflect biological processes independent of hemoglobin glycation and erythrocyte turnover. DESIGN: Cross-sectional. SETTING: Community-based. PARTICIPANTS: 1376 nondiabetic and 343 diabetic adults in a substudy of the Atherosclerosis Risk in Communities Study. MEASUREMENTS: Hemoglobin A(1c), fasting glucose, glycated albumin, fructosamine, and 1,5-anhydroglucitol levels. RESULTS: Among persons with and without diabetes, black persons had significantly higher HbA(1c), glycated albumin, and fructosamine levels than white persons before and after adjustment for covariates and fasting glucose concentration. Serum 1,5-anhydroglucitol levels, which are reduced in the setting of hyperglycemia-induced glycosuria, were lower in black persons than in white persons, although this difference was statistically significant only in nondiabetic adults. LIMITATION: The design was cross-sectional, a limited number of participants with a history of diabetes was included, and the study did not include integrated measures of circulating nonfasting glycemia. CONCLUSION: Differences between black and white persons in glycated albumin, fructosamine, and 1,5-anhydroglucitol levels parallel differences between these groups in HbA(1c) values. Racial differences in hemoglobin glycation and erythrocyte turnover cannot explain racial disparities in these serum markers. The possibility that black persons have systematically higher levels of nonfasting glycemia warrants further study. PRIMARY FUNDING SOURCE: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. |
DOI | 10.7326/0003-4819-154-5-201103010-00004 |
Alternate Journal | Ann Intern Med |
PubMed ID | 21357907 |
PubMed Central ID | PMC3131743 |
Grant List | N01HC55020 / HL / NHLBI NIH HHS / United States N01HC55018 / HL / NHLBI NIH HHS / United States K01 DK076595-03 / DK / NIDDK NIH HHS / United States N01-HC-55016 / HC / NHLBI NIH HHS / United States K01 DK076595-04 / DK / NIDDK NIH HHS / United States N01HC55015 / HL / NHLBI NIH HHS / United States K01 DK076595 / DK / NIDDK NIH HHS / United States N01-HC-55019 / HC / NHLBI NIH HHS / United States K01 DK076595-05 / DK / NIDDK NIH HHS / United States K24 DK62222 / DK / NIDDK NIH HHS / United States K01 DK076595-02 / DK / NIDDK NIH HHS / United States R21 DK080294 / DK / NIDDK NIH HHS / United States K24 DK062222 / DK / NIDDK NIH HHS / United States N01-HC-55022 / HC / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States N01HC55022 / HL / NHLBI NIH HHS / United States N01-HC-55021 / HC / NHLBI NIH HHS / United States N01-HC-55015 / HC / NHLBI NIH HHS / United States R21 DK080294-01 / DK / NIDDK NIH HHS / United States K01 DK076595-01 / DK / NIDDK NIH HHS / United States P60 DK079637 / DK / NIDDK NIH HHS / United States N01-HC-55020 / HC / NHLBI NIH HHS / United States N01HC55016 / HL / NHLBI NIH HHS / United States N01HC55019 / HL / NHLBI NIH HHS / United States R21 DK080294-02 / DK / NIDDK NIH HHS / United States N01-HC-55018 / HC / NHLBI NIH HHS / United States N01HC55021 / HL / NHLBI NIH HHS / United States |