Ethnic variation in the correlation between fasting glucose concentration and glycated hemoglobin (HbA1c)
Abstract
OBJECTIVE: We aimed to determine the relationship between fasting serum glucose (FSG) concentration and glycated hemoglobin-A1c (HbA1c) in the 3 ethnicities in Singapore after adjustment for demographic and therapeutic variables.
METHODS: Fasting serum glucose (FSG), HbA1c, and serum creatinine levels were simultaneously sampled from 575 patients with diabetes (389 Chinese, 97 Indians, 89 Malays) in this cross-sectional study between January and May 2008, and the results were subjected to multivariate linear regression analysis.
RESULTS: We found a significant interaction between FSG and ethnicity on HbA1c. The correlation between FSG and HbA1c among Chinese subjects was 0.25 (95% confidence interval [CI]:0.2-0.3) relative to the Malays (0.38, 95% CI: 0.30-0.45) after adjustment for age; gender; serum creatinine concentrations; body mass index (BMI); duration of diabetes; use of sulfonylureas, metformin, and insulin; and hemoglobin (Hb) and red cell indices (P = .005). Hence, for a given FSG, the predicted HbA1c will be higher in Malays compared to Chinese subjects. We did not observe a statistically significant difference between Indians and Malays with respect to the correlation between FSG and HbA1c.
CONCLUSION: We showed a higher correlation between HbA1c and FSG in Malay subjects relative to the Chinese in this cohort. The ethnic variation in the HbA1c-FSG relationship may be related to differences in percentage contribution by the FSG to overall HbA1c among ethnic…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 575 participants or records.
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