Do glycemic marker levels vary by race? Differing results from a cross-sectional analysis of individuals with and without diagnosed diabetes.
Do glycemic marker levels vary by race? Differing results from a cross-sectional analysis of individuals with and without diagnosed diabetes.
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DOI：
10.1136/bmjdrc-2016-000213
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发表时间：
2016
影响因子：
4.1
通讯作者：
Lewis CE
中科院分区：
文献类型：
--
作者：
Carson AP;Muntner P;Selvin E;Carnethon MR;Li X;Gross MD;Garvey WT;Lewis CE
众所周知，A1c因种族而异。然而，高血糖的其他生物标志物的种族差异并没有得到很好的表征。这项研究的目的是确定患有和不患有糖尿病的成年人在考虑挑战后血糖前后的平均血糖标志物水平是否因种族而不同。这项横断面研究包括2692名中年男性和女性(5.5%被诊断为糖尿病；44%是非洲裔美国人；56%是白人)，他们来自青年冠状动脉风险发展研究(2005-2006)，他们测量了空腹血糖、挑战后2小时血糖、糖化白蛋白、果糖胺和1，5-脱水葡萄糖醇(1，5-AG)。采用多元线性回归方法评估各血糖标志物平均水平的种族差异，按糖尿病状况分层，并根据社会人口学、心血管因素和挑战后血糖进行调整。在诊断为糖尿病的患者中，没有观察到任何血糖标志物的种族差异。在未诊断为糖尿病的人群中，非裔美国人的A1c(β=0.19%分；95%CI 0.14~0.24分)、糖化白蛋白(β=0.82%分；95%CI 0.68~0.97分)、果糖胺(β=8.68 μ/L；95%CI 6.68~10.68分)、2小时血糖(β=3.5 mg/dL；95%CI 0.10~6.90分)的均值高于白人，而1，5-AG的种族差异无统计学意义。在进一步调整空腹和2小时血糖后，观察到的A1c、糖化白蛋白和果糖胺的种族差异仍然存在，并且具有相似的幅度(SD单位)。在没有诊断出糖尿病的中年人中，即使在对挑战后血糖进行调整后，血糖标志物水平的种族差异也是明显的。这些高血糖生物标志物的种族差异是否会影响并发症的风险，还需要进一步研究。
It is well known that A1c varies by race. However, racial differences in other biomarkers of hyperglycemia are less well characterized. The objective of this study was to determine whether average levels of glycemic markers differ by race in adults with and without diagnosed diabetes, before and after accounting for postchallenge glucose. This cross-sectional study included 2692 middle-aged men and women (5.5% with diagnosed diabetes; 44% African-American; and 56% white) from the Coronary Artery Risk Development in Young Adults Study (2005–2006) who had fasting glucose, 2-hour postchallenge glucose, A1c, glycated albumin, fructosamine, and 1,5-anhydroglucitol (1,5-AG) measured. Multiple linear regression was used to evaluate racial differences in mean levels of each glycemic marker stratified by the diabetes status and adjusted for sociodemographics, cardiovascular factors, and postchallenge glucose. Among those with diagnosed diabetes, racial differences were not observed for any of the glycemic markers. In contrast, among those without diagnosed diabetes, African-Americans had higher mean levels than whites of A1c (β=0.19% points; 95% CI 0.14 to 0.24), glycated albumin (β=0.82% points; 95% CI 0.68 to 0.97), fructosamine (β=8.68 μmol/L; 95% CI 6.68 to 10.68), and 2-hour glucose (β=3.50 mg/dL; 95% CI 0.10 to 6.90) after multivariable adjustment, whereas there were no statistically significant racial difference in 1,5-AG. The racial differences observed for A1c, glycated albumin, and fructosamine persisted after further adjustment for fasting and 2-hour glucose and were of similar magnitude (SD units). Racial differences in glycemic marker levels were evident among middle-aged adults without diagnosed diabetes even after adjustment for postchallenge glucose. Whether these racial differences in biomarkers of hyperglycemia affect the risk of complications warrants additional study.