A1C Combined With Glycated Albumin Improves Detection of XXXX in Africans: The Africans in America Study.

@entity3916 @entity6 @entity5710 @entity9208 @entity413
OBJECTIVE: Slowing the @entity6 in Africa requires improved detection of @entity5710 . @entity3916 , a form of glycated hemoglobin A, is recommended for diagnosing @entity5710 . The glycated proteins, @entity9208 and glycated albumin (GA), are hemoglobin-independent alternatives to @entity3916 , but their efficacy in Africans is unknown. Our goals were to determine the ability of @entity3916 , @entity9208 , and GA to detect @entity5710 in U.S.-based Africans and the value of combining @entity3916 with either @entity9208 or GA. RESEARCH DESIGN AND METHODS: Oral @entity413 tolerance tests (OGTT) were performed in 217 self-identified healthy African immigrants (69% male, age 39    10 years [mean    SD], BMI 27.6    4.5 kg/m(2)). @entity3916 , @entity9208 , and GA were measured. @entity5710 was diagnosed by American @entity6 Association criteria for @entity413 obtained from a 2-h OGTT. The thresholds to diagnose @entity5710 by @entity3916 , @entity9208 , and GA were the cutoff at the upper tertile for each variable: >= 5.7% (39 mmol/mol) (range 4.2-6.6% [22.4-48.6 mmol/mol]), >= 230   mol/L (range 161-269   mol/L) and >= 13.35% (range 10.20-16.07%), respectively. RESULTS: @entity5710 occurred in 34% (74 of 217). The diagnostic sensitivities of @entity3916 , @entity9208 , and GA were 50%, 41%, and 42%, respectively. The P values for comparison with @entity3916 were both >0.3. Combining @entity3916 with either @entity9208 or GA increased sensitivities. However, the sensitivity of @entity3916 combined with @entity9208 was not better than for @entity3916 alone (72% vs. 50%, P = 0.172). In contrast, the sensitivity of @entity3916 combined with GA was higher than for @entity3916 alone (78% vs. 50%, P < 0.001). CONCLUSIONS: As individual tests, @entity3916 , @entity9208 , and GA detected  <=50% of Africans with @entity5710 . However, combining @entity3916 with GA made it possible to identify nearly 80% of Africans with @entity5710 .
