Variation in the relationship between fasting glucose and HbA1c: implications for the diagnosis of diabetes in different age and ethnic groups
Authors' conclusion
FPG-HbA1c relationship is affected by non-glycemic factors leading to incorrect diagnosis of diabetes in some individuals and ethnic groups. Assessment of AGR helps understand individual-specific relationship between glucose levels and HbA1c, which has the potential to more accurately diagnose and manage diabetes.
Study context
- Population
- Individuals from the 2001–2018 US National Health and Nutrition Examination Survey
- Participants
- 12,531 individuals
- Exposure
- HbA1c at fasting plasma glucose (FPG) 7 mmol/L by race, age and gender
- Outcome
- FPG-HbA1c relationship; HbA1c at FPG of 7 mmol/L and apparent glycation ratio (AGR) by age, race and gender
Main finding
As reported in the abstract
HbA1c at FPG of 7 mmol/L
| Group | Value | NGSP units |
|---|---|---|
| Black | mean 50.2 (CI 49.8–50.4) mmol/mol | 6.7% |
| White | 47.4 (CI 47.2–47.5) mmol/mol | 6.5% |
| Under 21 years | 47.9 (CI 47.7–48.1) mmol/mol | 6.5% |
| Over 50 years | 48.3 (CI 48.2–48.5) mmol/mol | 6.6% |
| Women | 49.2 (CI 49.1–49.3) mmol/mol | 6.7% |
| Men | 47.0 (CI 46.8–47.1) mmol/mol | 6.5% |
Value
Blackmean 50.2 (CI 49.8–50.4) mmol/mol
White47.4 (CI 47.2–47.5) mmol/mol
Under 21 years47.9 (CI 47.7–48.1) mmol/mol
Over 50 years48.3 (CI 48.2–48.5) mmol/mol
Women49.2 (CI 49.1–49.3) mmol/mol
Men47.0 (CI 46.8–47.1) mmol/mol
NGSP units
Black6.7%
White6.5%
Under 21 years6.5%
Over 50 years6.6%
Women6.7%
Men6.5%
- Black vs White: P < 0.001 — higher HbA1c in black individuals
- Under 21 years vs Over 50 years: P < 0.001 — lower HbA1c under 21 years
- Women vs Men: P < 0.001
- Difference in HbA1c at FPG 7 mmol/L, black females over 50 vs white males under 21 years
- 5 mmol/mol (0.46%)
Observational data: associations, not effects.
Further findings
- Apparent glycation ratio (AGR) differences by race
- P < 0.001
- AGR differences by age
- P < 0.001
- AGR differences by gender
- P < 0.001
- AGR differences explained altered glucose-HbA1c relationship in the analyzed groups
Original publication
Variation in the relationship between fasting glucose and HbA1c: implications for the diagnosis of diabetes in different age and ethnic groups. BMJ Open Diabetes Res Care. Published 4 March 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →