平均葡萄糖与血红蛋白A1c之间的关联中的种族和种族差异
Andrew J Karter1,2,3, Melissa M Parker1, Howard H Moffet1
1Kaiser Permanente-Division of Research, Oakland, California, USA.
Diabetes technology & therapeutics
|August 3, 2023
概括
与白人相比,黑人美国人的血红蛋白A1C (A1C) 可能会高估血糖. 建议使用持续葡萄糖监测 (CGM) 进行个性化糖尿病护理,因为大多数葡萄糖-A1C变化发生在种族群体内.
科学领域:
- 内分泌学 在内分泌学.
- 糖尿病研究研究 糖尿病研究
- 临床化学 临床化学
背景情况:
- 研究表明,非裔美国患者的血红蛋白A1c (A1C) 含量较高,而白人患者的平均葡萄糖水平相似.
- 在非裔美国人之外,A1C-葡萄糖关系的种族/种族变异数据有限.
研究的目的:
- 通过持续血糖监测 (CGM) 测量平均葡萄糖与A1C之间的关联中调查种族和种族差异.
- 为了确定A1C是否准确地反映了不同种族/种族群体的平均葡萄糖水平.
主要方法:
- 一项回顾性研究分析了在2016-2021年期间使用CGM设备的1788名糖尿病患者的数据.
- 平均葡萄糖从超过1.24亿次CGM读数计算出来,前面有5264次A1C结果.
- 使用层次混合效应模型来评估葡萄糖-A1C关联中的种族/民族差异.
主要成果:
- 非洲裔美国患者的平均A1C比白人患者高0.33个百分点,相当于平均葡萄糖水平.
- 白人患者和亚裔,拉丁裔或多民族患者之间没有观察到A1C的显著差异.
- 葡萄糖-A1C关联的斜率在种族/种族群体之间没有显著变化,大多数变化发生在群体内 (65%).
结论:
- 非洲裔美国患者的A1C结果可能会高估血糖,可能导致误诊或过度治疗.
- 个性化糖尿病管理,包括直接测量葡萄糖,至关重要,尤其是在依赖A1C治疗决策时.
- 实质性的群体内变异性强调需要个性化血糖评估超越基于种族的A1C解释.
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