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Cited by 86Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and ResearchAdipokines, Inflammation, and Metabolic Diseases

Is Glycosylated Hemoglobin A1c a Surrogate for Metabolic Syndrome in Nondiabetic, First-Degree Relatives of African-American Patients with Type 2 Diabetes?

Osei, Kwame, Rhinesmith, Scott, Gaillard, Trudy, Schuster, Dara·2003·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2003-030686
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Abstract

Glycosylated hemoglobin (Hb)A1c provides a practical assessment of long-term glycemic control in patients with diabetes. However, whether HbA1c has any clinical significance in metabolic syndrome (MS) in nondiabetic subjects remains debatable. Therefore, we examined the impact of different levels of HbA1c on insulin sensitivity (Si), non-insulin-dependent glucose disposal, and blood pressure (BP), as well as lipids and lipoproteins in nondiabetic, first-degree relatives of African-American patients with type 2 diabetes. The study consisted of 219 nondiabetic, first-degree relatives (offspring and siblings) of African-American patients with type 2 diabetes. To examine the metabolic impact of HbA1c in our population, HbA1c was divided into tertiles (normal range, 3.3–6.4%). The mean HbA1c was 4.7% (range, 3.3–4.8%, n = 74) for tertile 1, 5.4% (range, 4.9–5.6%, n = 73) for tertile 2, and 5.8% (range, 5.7–6.4%, n = 72) for tertile 3. Si and glucose effectiveness (Sg) were determined by the Bergman’s minimal model method. Homeostasis model assessment (HOMA)-insulin resistance and HOMA-β-cell function were also estimated. BP, body compositional variables, and body fat distribution, as well as fasting serum lipid and lipoprotein concentrations, were determined in each subject. The mean age, body weight, body mass index, waist and hip circumference, and systolic and diastolic BPs were significantly (P < 0.02–0.001) greater in the subjects in tertile 3 than those in tertiles 1 and 2. The mean fasting serum glucose was significantly (P < 0.01) higher in tertile 3 (95.5 ± 3.2 mg/dl) than in tertile 2 (83.0 ± 2.7 mg/dl) and tertile 1 (78.8 ± 1.5 mg/dl). Mean fasting serum insulin and c-peptide levels tended to be higher in tertile 3 subjects than in those in tertiles 1 and 2, but the mean differences did not reach statistical significance. The mean Si was significantly (P < 0.001) lower in the subjects in tertile 3 [1.66 ± 0.2019 × 10−4·min−1(μU/ml)−1], when compared with those in tertile 1 [2.27 ± 0.20 19 × 10−4·min−1(μU/ml)−1] and tertile 2 [2.61 ± 0.19 × 10−4·min−1(μU/ml)−1]. The mean Sg was significantly (P < 0.02) lower in tertile 3 (1.95 ± 0.12 × 10−2·min−1), when compared with those of tertile 1 (2.27 ± 0.10 × 10−2·min−1) and tertile 2 (2.29 ± 0.11 × 10−2·min−1). In addition, the (HOMA)-insulin resistance was significantly (P < 0.01) higher in tertile 3 (3.62 ± 0.26) than in tertile 1 (2.6 ± 0.21) and tertile 2 (2.55 ± 0.31) HbA1c. In contrast, HOMA-β-cell function, was not different among tertiles 1, 2, and 3. Mean fasting serum triglycerides, cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels also were not significantly different in subjects in tertile 3, when compared with those in tertiles 1 and 2. In summary, the present study demonstrates that the upper tertile HbA1c level (tertile 3) reflects some components of MS in the nondiabetic, obese, first-degree relatives of African-Americans who are genetically predisposed to type 2 diabetes. The metabolic abnormalities in the upper tertile 3 subjects included a reduced insulin action (Si) and reduced Sg, as well as elevated systolic and diastolic BPs, but not β-cell secretion and lipids and lipoproteins. We conclude that the upper tertile of HbA1c should be considered as a major surrogate of MS in high-risk African-Americans who are genetically predisposed to type 2 diabetes.

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  • Similar SES gradients are seen for blood pressure, total and HDL cholesterol, and C-reactive protein, with lower SES associated with a higher prevalence of high-risk values for all of these parameters.

    “As shown in Figure 2, similar SES gradients are seen for a wide array of additional biological risk factors, including blood pressure, total and HDL cholesterol, and C-reactive protein (CRP) with lower SES associated with a higher prevalence of”

    From Socio‐economic differentials in peripheral biology: Cumulative allostatic load (2010) · cites this paper as [77]

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Authors
Osei, K., Rhinesmith, S., Gaillard, T., & Schuster, D.
Affiliations
The Ohio State University (US)
Corresponding author
Osei, Kwame
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2003-10-01
Volume
88
Issue
10
Pages
4596-4601
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2003-030686
OpenAlex
W2153636216
Cited by
86
References
65
Citations by year
2025: 1 · 2024: 3 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 1 · 2012: 7
FWCI
1.63
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Ohio State University
  • National Institutes of Health (5r01dk048127-05, GCRC-RR0034)
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK 48127)
  • National Center for Research Resources (M01RR000034)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
glycosylated hemoglobin A1c, metabolic syndrome, type 2 diabetes, first-degree relatives, African American patients, insulin sensitivity, insulin resistance, glucose effectiveness, beta-cell function, blood pressure, lipoproteins, body composition, waist-to-hip ratio, prediabetes, glycemic control, HOMA-IR, HOMA-β, C-peptide
MeSH terms
Adult, Black or African American, Diabetes Mellitus, Diabetes Mellitus, Type 2, Family Health, Female, Glycated Hemoglobin, Homeostasis, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Risk Factors, Incidence, Prevalence, Metabolic Syndrome

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