Ethnic disparity in hemoglobin A1c levels among normoglycemic offspring of parents with type 2 diabetes mellitus

Emmanuel Chapp-Jumbo, Chimaroke Edeoga, Jim Wan, Samuel Dagogo-Jack

Research output: Contribution to journalArticle

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Abstract

Objective: To investigate the racial/ethnic disparities in hemoglobin A1c levels among nondiabetic persons with similar parental history of type 2 diabetes mellitus.Methods: We studied a community-based sample of adult offspring of parents with type 2 diabetes mellitus. Measurements included anthropometry, hematology assessments, serial fasting plasma glucose, oral glucose tolerance testing, plasma insulin, hemoglobin A1c, insulin sensitivity, and β-cell function, using a homeostasis model assessment.Results: The study included 302 participants (135 white, 167 black). Compared with white participants, black participants had lower fasting plasma glucose levels (91.9 ± 0.51 mg/dL vs 93.6 ± 0.50 mg/dL, P = .015), lower area under the curve of plasma glucose during oral glucose tolerance testing (P = <.001), higher body mass index (31.1 ± 0.61 kg/m 2 vs 28.5 ± 0.57 kg/m2, P = <.001), and similar insulin sensitivity and β-cell function. Hemoglobin A1c was higher in black participants than in white participants (5.68 ± 0.033% vs 5.45 ± 0.028%, P<.001). The absolute black-white difference in hemoglobin A1c level of approximately 0.22% persisted after adjusting for age, hemoglobin, hematocrit, body mass index, waist circumference, fasting plasma glucose, glucose area under the curve, and other covariates.Conclusions: Among healthy offspring of parents with type 2 diabetes mellitus in this study, African American participants had higher hemoglobin A1c levels than white participants after adjusting for age, adiposity, blood glucose, and known variables. Thus, plasma glucose level is more valid than hemoglobin A 1c for diagnosing prediabetes or diabetes in black persons.

Original languageEnglish (US)
Pages (from-to)356-362
Number of pages7
JournalEndocrine Practice
Volume18
Issue number3
DOIs
StatePublished - May 1 2012

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Type 2 Diabetes Mellitus
Hemoglobins
Parents
Glucose
Fasting
Glucose Tolerance Test
Area Under Curve
Insulin Resistance
Body Mass Index
Hemoglobin A
Prediabetic State
Anthropometry
Adiposity
Adult Children
Waist Circumference
Hematology
Hematocrit
African Americans
Blood Glucose
Homeostasis

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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Ethnic disparity in hemoglobin A1c levels among normoglycemic offspring of parents with type 2 diabetes mellitus. / Chapp-Jumbo, Emmanuel; Edeoga, Chimaroke; Wan, Jim; Dagogo-Jack, Samuel.

In: Endocrine Practice, Vol. 18, No. 3, 01.05.2012, p. 356-362.

Research output: Contribution to journalArticle

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N2 - Objective: To investigate the racial/ethnic disparities in hemoglobin A1c levels among nondiabetic persons with similar parental history of type 2 diabetes mellitus.Methods: We studied a community-based sample of adult offspring of parents with type 2 diabetes mellitus. Measurements included anthropometry, hematology assessments, serial fasting plasma glucose, oral glucose tolerance testing, plasma insulin, hemoglobin A1c, insulin sensitivity, and β-cell function, using a homeostasis model assessment.Results: The study included 302 participants (135 white, 167 black). Compared with white participants, black participants had lower fasting plasma glucose levels (91.9 ± 0.51 mg/dL vs 93.6 ± 0.50 mg/dL, P = .015), lower area under the curve of plasma glucose during oral glucose tolerance testing (P = <.001), higher body mass index (31.1 ± 0.61 kg/m 2 vs 28.5 ± 0.57 kg/m2, P = <.001), and similar insulin sensitivity and β-cell function. Hemoglobin A1c was higher in black participants than in white participants (5.68 ± 0.033% vs 5.45 ± 0.028%, P<.001). The absolute black-white difference in hemoglobin A1c level of approximately 0.22% persisted after adjusting for age, hemoglobin, hematocrit, body mass index, waist circumference, fasting plasma glucose, glucose area under the curve, and other covariates.Conclusions: Among healthy offspring of parents with type 2 diabetes mellitus in this study, African American participants had higher hemoglobin A1c levels than white participants after adjusting for age, adiposity, blood glucose, and known variables. Thus, plasma glucose level is more valid than hemoglobin A 1c for diagnosing prediabetes or diabetes in black persons.

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