Abstract P145: Evaluating the Diagnostic Efficacy of A1C, Fructosamine and Glycated Albumin in Determining Glucose Tolerance Status in Africans: The Africans in America Study
As both diabetes and pre-diabetes are common in Africa, screening tests must be rapid, simple, and accurate. Hemoglobin A1C (A1C), fructosamine, and glycated albumin (GA) are screening tests of long term glycemia which only require one blood sample obtained any time of day without consideration of recent nutrient intake. A1C is already recommended as a screening test for diabetes by the American Diabetes Association and the International Diabetes Federation, but fructosamine and GA are under active evaluation. Fructosamine is a measure of circulating glycated protein. GA is a subfraction of fructosamine. Data on the effectiveness of fructosamine and GA in African descent populations are scant. Therefore, our goal was to compare the ability of A1C, fructosamine, and GA to predict diabetes. Two hour OGTT were performed in 230 African immigrants (67% male; age 37±10y (mean±SD); BMI: 27.6±4.6 kg/m2). Glucose tolerance category was defined by 2h glucose levels (normal: 2h glucose<140 mg/dL; pre-diabetes: 2h glucose ≥140 mg/dL and <200 mg/dL; diabetes: 2h glucose ≥200 mg/dL). A1C was measured in all participants while fructosamine and GA levels were available in 153 of the enrollees. Pre-diabetes was identified in 26% (61/230) of the participants and diabetes was detected in 7% (15/230). By one-way ANOVA, A1C, fructosamine and GA were higher if diabetes was present (all P<0.01) but did not differ significantly in the normal and pre-diabetes categories. For the prediction of diabetes, area under the receiver operator characteristic (AUC-ROC) curves was higher for GA than either fructosamine or A1C (Table). Overall, in African immigrants, each of the three tests was able to identify diabetes, but none were able to distinguish between normal glucose tolerance and pre-diabetes. Among the three tests, GA may be the best predictor of diabetes.
Author Disclosures: M.T. Duong: None. C.K. Thoreson: None. S.T. Chung: None. P.C. Aldana: None. M. Ricks: None. L.S. Mabundo: None. D.B. Sacks: None. A.E. Sumner: None.
- © 2015 by American Heart Association, Inc.