As diabetes prevalence rises in Africa, tests to detect abnormal glucose tolerance (abnl-GT) must be optimized. Recent reports suggest A1C performs well as a diagnostic test for abnl-GT in the OB. In contrast, glycated albumin (GA) contributes to the detection of abnl-GT in the nonobese. To determine if BMI affects sensitivity of A1C and GA in Africans, we evaluated the sensitivity of A1C and GA separately and combined to detect abnl-GT in 88 OB blacks (age 42±10y, BMI 33.4±2.9, range 30.0-42.4) and 232 nonobese blacks (age 38±10y, BMI 25.5±2.6, range 18.2-29.8) who were born in Africa and live in the U.S.A. Abnl-GT was determined by glucose criteria for the OGTT. Thresholds for A1C and GA were defined by the cut-off at their upper quartile (A1C≥5.7%; GA ≥13.97%). Prevalence of abnl-GT in OB and nonobese Africans were: 43% v 35%, P=0.20, resp. In the OB, sensitivities of A1C, GA and the combined tests were: 67%, 29% and 79% resp (Figure A). In the OB, sensitivity of A1C + GA was similar to A1C alone (P=0.13). For the nonobese, sensitivities of A1C, GA and the combined tests were: 35%, 38% and 62% resp (Figure B). Sensitivity increased when the tests were combined because abnl-GT was detected in 22 nonobese Africans not identified by A1C. Patterns were similar by sex and region of Africa. Data from Africans living in the U.S.A suggest detection of abnl-GT in the nonobese is improved by combining A1C with GA.
J. Kabakambira: None. S.M. Briker: None. R.L. Baker: None. C. DuBose: None. L. Mabundo: None. S.T. Chung: None. D.B. Sacks: Other Relationship; Self; Sebia, Trinity Biotech. A.E. Sumner: None.
