Improved Detection of Abnormal Glucose Tolerance in Africans: The Value of Combining Hemoglobin A1c With Glycated Albumin

Abstract

In African-born Blacks living in America, we determined by BMI category 1) prevalence of abnormal glucose tolerance (Abnl-GT) and 2) diagnostic value and reproducibility of hemoglobin A1c (HbA1c), fructosamine, and glycated albumin (GA). Participants (n 5 416; male, 66%; BMI 27.7 6 4.5 kg/m2 [mean 6 SD]) had an oral glucose tolerance test with HbA1c, GA, and fructosamine assayed. These glycemic markers were repeated 11 6 7 days later. Abnl-GT diagnosis required 0 h ‡5.6 mmol/L (‡100 mg/dL) and/or 2 h ‡7.8 mmol/L (‡140 mg/dL). Thresholds for HbA1c, GA, and fructosamine were the values at the 75th percentile for the population (39 mmol/ mol [5.7%], 14.2%, and 234 mmol/L, respectively).