Ethnic variation in the correlation between fasting glucose concentration and glycated hemoglobin (HbA1c).

Endocr Pract

Department of Endocrinology, Tan Tock Seng Hospital, Singapore Yong Loo Lin School of Medicine, Singapore Duke-NUS Graduate Medical School, Singapore.

Published: June 2014

AI Article Synopsis

  • The study investigated how fasting serum glucose (FSG) relates to glycated hemoglobin-A1c (HbA1c) among different ethnic groups in Singapore, including Chinese, Indians, and Malays.
  • There was a notable difference in the correlation between FSG and HbA1c, with Malays showing a stronger relationship than Chinese subjects after adjusting for various factors like age and BMI.
  • The findings suggest ethnic variations in how FSG contributes to HbA1c levels, indicating that further research using continuous glucose monitoring is needed to understand these differences better.

Article 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 groups. Future studies using continuous glucose monitoring (CGM) to elucidate the relative contributions by FSG and postprandial glucose (PPG) to the daily blood glucose profile and the overall HbA1c by ethnicity are required.

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http://dx.doi.org/10.4158/EP12417.ORDOI Listing

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