Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program
Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program
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DOI：
10.2337/dc06-2003
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发表时间：
2007-10-01
期刊：
影响因子：
16.2
通讯作者：
Barrett-Connor, Elizabeth
中科院分区：
文献类型：
--
作者：
Herman, William H.;MA, Yong;Barrett-Connor, Elizabeth
目的：研究糖耐量受损（IGT）患者At C的种族差异。研究设计和方法：我们研究了3819名年龄在bb0 = 25岁的IGT患者，他们被发现有资格参加糖尿病预防计划。对5个种族和民族的AIC进行校正前后比较，以校正组间差异或可能影响血糖的因素，包括年龄、性别、教育程度、婚姻状况、血压、肥胖（BMI和腰围）、红细胞压积、空腹和糖负荷后血糖水平、葡萄糖曲线下面积（AUC）、β细胞功能和胰岛素抵抗。结果-平均+/- SD AIC为5.91 +/- 0.50%。白人的AIC为5.80 +/- 0.44%，西班牙裔为5.89 +/- 0.46%，亚裔为5.96 +/- 0.45%，美洲印第安人为5.96 +/- 0.46%，黑人为6.19 +/- 0.59%。年龄、性别、收缩压、舒张压、BMI、空腹血糖、葡萄糖AUC、校正胰岛素反应和胰岛素抵抗均为AIC的独立预测因子。调整这些因素和其他因素后，白人的平均AIC水平为5.78%，西班牙裔为5.93%，亚洲人为6.00%，美洲印第安人为6.12%，黑人为6.18% （P < 0.001）。结论：在对可能影响血糖的因素进行调整后，美国种族和少数民族IGT患者的AIC水平较高。在IGT患者中，AlC可能不能有效地评估和比较不同种族和民族的血糖控制，也不能作为医疗保健差异的指标。
OBJECTIVE - We sought to examine racial and ethnic differences in At C in individuals with impaired glucose tolerance (IGT).RESEARCH DESIGN AND METHODS - We studied 3,819 individuals aged >= 25 years with IGT who were found to be eligible to participant in the Diabetes Prevention Program. AIC was compared among five racial and ethnic groups before and after adjustment for factors that differed among groups or might affect glycemia including age, sex, education, marital status, blood pressure, adiposity (BMI and waist circumference), hematocrit, fasting and post-glucose load glucose levels, glucose area under the curve (AUC), beta-cell function, and insulin resistance.RESULTS - Mean +/- SD AIC was 5.91 +/- 0.50%. Among whites, AIC was 5.80 +/- 0.44%, among Hispanics 5.89 +/- 0.46%, among Asian 5.96 +/- 0.45%, among American Indians 5.96 +/- 0.46%, and among blacks 6.19 +/- 0.59%. Age, sex, systolic blood pressure, diastolic blood pressure, BMI, fasting glucose, glucose AUC, corrected insulin response, and insulin resistance were eachindependent predictors of AIC. Adjusting for these and other factors, mean AIC levels were 5.78% forwhites, 5.93% for Hispanics, 6.00% forAsians, 6.12% for American Indians, and 6.18% for blacks (P < 0.001).CONCLUSIONS - AIC levels are higher among U.S. racial and ethnic minority groups with IGT after adjustment for factors likely to affect glycemia. Among patients with IGT, AlC may not be valid for assessing and comparing glycemic control across racial and ethnic groups or as an indicator of health care disparities.