Hemoglobin A1c and Race: Should Therapeutic Targets and Diagnostic Cutoffs Differ among Racial Groups?

Sacks, David B.

doi:10.1373/clinchem.2016.255166

Cited by 8 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this meta-analysis we provided information on the amount of these differences, expressed as HbA1c absolute values, in individuals without DM. Whether different therapeutic targets and diagnostic cut-off points for DM should be used among ethnic groups is still unclear [ 54 , 55 ]. A proper evaluation of the glycemic impact on HbA1c levels in different ethnicities could resolve the issue.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of ethnicity on HbA1c levels in individuals without diabetes: Systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

Aims/HypothesisDisparities in HbA1c levels have been observed among ethnic groups. Most studies were performed in patients with diabetes mellitus (DM), which may interfere with results due to the high variability of glucose levels. We conducted a systematic review and meta-analysis to investigate the effect of ethnicity on HbA1c levels in individuals without DM.MethodsThis is a systematic review with meta-analysis. We searched MEDLINE and EMBASE up to September 2016. Studies published after 1996, performed in adults without DM, reporting HbA1c results measured by certified/standardized methods were included. A random effects model was used and the effect size was presented as weighted HbA1c mean difference (95% CI) between different ethnicities as compared to White ethnicity.ResultsTwelve studies met the inclusion criteria, totalling data from 49,238 individuals. There were significant differences between HbA1c levels in Blacks [0.26% (2.8 mmol/mol); 95% CI 0.18 to 0.33 (2.0 to 3.6), p <0.001; I2 = 90%, p <0.001], Asians [0.24% (2.6 mmol/mol); 95% CI 0.16 to 0.33 (1.7 to 3.6), p <0.001; I2 = 80%, p = 0.0006] and Latinos [0.08% (0.9 mmol/mol); IC 95% 0.06 to 0.10 (0.7 to 1.1); p <0.001; I2 = 0%; p = 0.72] when compared to Whites.Conclusions/InterpretationThis meta-analysis shows that, in individuals without DM, HbA1c values are higher in Blacks, Asians, and Latinos when compared to White persons. Although small, these differences might have impact on the use of a sole HbA1c point to diagnose DM in all ethnic populations.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, until now no published study in this field has adequately addressed this question [ 54 ]. Despite this, the individualization of glycaemic goals has been highlighted in the recent years and personalized approaches for medical care, based on patient clinical characteristics, are recommended [ 55 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of ethnicity on HbA1c levels in individuals without diabetes: Systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The non-glycaemic dependent factors include a) variable glycation among individuals; b) variable rates of deglycation, i.e., the rate of glucose removed from HbA1c; c) genetics, whereby there are approximately 15 genomic loci found to influence HbA1c based on large-scale, genome-wide association studies, which may have a measurable effect on the HbA1c (24) and d) RBC lifespan. Reduced removal of senescent RBC from the circulation causes higher HbA1c, and thus variation in RBC turnover may contribute to the variation in HbA1c among ethnic groups (24).…”

Section: Discussionmentioning

confidence: 99%

Glycated Haemoglobin as an Index of Glycaemic Control: Ethnic Variation among Patients with Type 2 Diabetes Mellitus in a Malaysian Tertiary Hospital

Arifin¹,

Thambiah²,

Abdullah³

et al. 2022

MJMHS

View full text Add to dashboard Cite

Introduction: Previous studies have revealed ethnic differences in glycated haemoglobin (HbA1c) value at the same glucose concentration. This study aimed to determine ethnic variation in HbA1c as an index of glycaemic control among type 2 diabetes mellitus (T2DM) patients. Methods: This cross-sectional, retrospective study recruited 293 T2DM patients by simple random sampling at the medical outpatient clinic of a tertiary hospital. Results: Ethnicity was equally distributed with 33.4% Malays and Indians, respectively, and 33.1% Chinese. Significant difference in ethnicity was noted between HbA1c groups ≤6.5% and >6.5%. Indians had the highest median HbA1c (8.3%), followed by Malays (7.7%) and Chinese (7.2%) [p=0.004]. Malays had lower HbA1c compared with Chinese at lower fasting plasma glucose (FPG) whereas Chinese had lower HbA1c compared with Malays at higher FPG, crossing over at FPG 2.8 mmol/L. Indians had higher HbA1c compared with Chinese and Malays except at FPG cross-over of 16 mmol/L where Malays were higher than Indians. FPG and ethnicity were independent predictors of HbA1c. An increase of 1 mmol/L in FPG resulted in an increase of 0.44% in HbA1c. Indians and Malays had 0.60% and 0.47% higher HbA1c, respectively, than Chinese. Conclusion: This pilot study in Malaysia examined ethnic variation in the relationship between FPG and HbA1c among T2DM patients. Since HbA1c is higher in Indians and Malays compared with Chinese at any given FPG, the hypoglycaemia risk may be increased in Indians and Malays when treatment strategies are focussed on using similar target HbA1c values to treat them.

show abstract

“…Other factors, such as pH and erythrocyte turnover, can also impact HbA1c levels (2). Furthermore, some individuals and racial groups consistently have higher or lower HbA1c levels than expected based on their blood glucose levels (3).…”

Section: Introductionmentioning

confidence: 99%

Association Between Glycated Hemoglobin Index and Triglycerides-Glucose Index in a Sample of Non-Diabetic Individuals and Its Relation With Insulin Resistance

Andrade

Oliveira

Oliveira³

et al. 2023

Preprint

View full text Add to dashboard Cite

Introduction Studies have shown that elevations of the triglyceride/glucose index (TyG) as well as the glycation of hemoglobin index (HGI) are associated with several complications related to insulin resistance (IR). Objective To evaluate the association between HGI and TyG index in a sample of non-diabetic individuals and it’s relation with IR. Method A cross-sectional study was conducted with 32 non-diabetic individuals. The variables analyzed included age, gender, body mass index, and laboratory data (triglycerides, glucose, HbA1c, and insulin). We calculated the TyG index, HOMA-IR, and HGI. Simple and multivariate linear regression analyses were also performed, in addition to ANOVA and Pearson's correlation between variables. Results The multivariate linear regression analysis of the analyzed sample revealed a significant correlation between the TyG index and HGI, which was confirmed by the T-test. The results indicated a strong positive correlation between the TyG index and HGI, with a Pearson correlation coefficient of 0.98. Conclusion The HGI, TyG index and IR showed a significant association in the analyzed sample. This suggests that both indices are highly reliable in measuring IR and glucose metabolism and may be markers of risk independent of FPG, and the other variables evaluated in this study.

show abstract

Hemoglobin A1c and Race: Should Therapeutic Targets and Diagnostic Cutoffs Differ among Racial Groups?

Cited by 8 publications

References 15 publications

Effect of ethnicity on HbA1c levels in individuals without diabetes: Systematic review and meta-analysis

Effect of ethnicity on HbA1c levels in individuals without diabetes: Systematic review and meta-analysis

Glycated Haemoglobin as an Index of Glycaemic Control: Ethnic Variation among Patients with Type 2 Diabetes Mellitus in a Malaysian Tertiary Hospital

Association Between Glycated Hemoglobin Index and Triglycerides-Glucose Index in a Sample of Non-Diabetic Individuals and Its Relation With Insulin Resistance

Contact Info

Product

Resources

About