Racial differences in glycemic markers: a cross-sectional analysis of community-based data
Elizabeth Selvin1, Michael W Steffes, Christie M Ballantyne
1Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. lselvin@jhsph.edu
Annals of Internal Medicine
|March 2, 2011
Summary
Racial disparities in diabetes markers persist, with Black individuals showing higher levels of glycated albumin and fructosamine. These differences in glycemic markers suggest potential underlying variations in nonfasting glucose levels between racial groups.
Area of Science:
- Endocrinology
- Clinical Chemistry
- Public Health
Background:
- Established differences in Hemoglobin A1c (HbA1c) between Black and White individuals may not accurately reflect glycemic control.
- Recent research suggests these HbA1c disparities might not be solely due to differences in blood glucose levels.
Purpose of the Study:
- To investigate racial disparities in various glycemic markers.
- To examine markers reflecting biological processes independent of hemoglobin glycation and erythrocyte turnover.
Main Methods:
- Cross-sectional, community-based study.
- Included 1376 nondiabetic and 343 diabetic adults from the Atherosclerosis Risk in Communities Study.
- Measured Hemoglobin A1c, fasting glucose, glycated albumin, fructosamine, and 1,5-anhydroglucitol.
Main Results:
- Black individuals had significantly higher HbA1c, glycated albumin, and fructosamine levels compared to White individuals, even after adjusting for covariates and fasting glucose.
- Serum 1,5-anhydroglucitol levels were lower in Black individuals, particularly in nondiabetic adults, indicating differences in glucose metabolism or excretion.
Conclusions:
- Observed differences in glycated albumin, fructosamine, and 1,5-anhydroglucitol levels parallel HbA1c disparities between Black and White persons.
- Racial differences in hemoglobin glycation and erythrocyte turnover do not fully explain these serum marker disparities.
- Further research is warranted to explore potential systematic differences in nonfasting glycemia among Black individuals.
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