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Racial differences in glycemic markers: a cross-sectional analysis of community-based data.

TitleRacial differences in glycemic markers: a cross-sectional analysis of community-based data.
Publication TypeJournal Article
Year of Publication2011
AuthorsSelvin E, Steffes MW, Ballantyne CM, Hoogeveen RC, Coresh J, Brancati FL
JournalAnn Intern Med
Volume154
Issue5
Pagination303-9
Date Published2011 Mar 01
ISSN1539-3704
KeywordsAfrican Continental Ancestry Group, Aged, Blood Glucose, Cross-Sectional Studies, Deoxyglucose, Diabetes Mellitus, Erythrocytes, European Continental Ancestry Group, Female, Fructosamine, Glycated Hemoglobin A, Humans, Male
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.

DOI10.7326/0003-4819-154-5-201103010-00004
Alternate JournalAnn Intern Med
PubMed ID21357907
PubMed Central IDPMC3131743
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
K01 DK076595-03 / DK / NIDDK NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
K01 DK076595-04 / DK / NIDDK NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI 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
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
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
N01-HC-55018 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
K24 DK062222 / DK / NIDDK NIH HHS / United States