Racial differences in and prognostic value of biomarkers of hyperglycemia
Open accessAbstract
OBJECTIVE: We compared levels and associations of traditional (fasting glucose, HbA1c) and nontraditional (fructosamine, glycated albumin, and 1,5-anhydroglucitol [1,5-AG]) biomarkers of hyperglycemia with incident cardiovascular disease (CVD), incident end-stage renal disease (ESRD), and prevalent retinopathy in black and white adults. RESEARCH DESIGN AND METHODS: We included 10,373 participants without (8,096 white, 2,277 black) and 727 with diagnosed diabetes (425 white, 302 black) from the Atherosclerosis Risk in Communities (ARIC) Study. We used Cox proportional hazards models to compare hazards ratios of CVD and ESRD among blacks and whites from baseline (1990–1992) through 2012. We compared the odds ratios (from logistic regression) of retinopathy among blacks and whites. We tested for the interaction of each biomarker with race. RESULTS: Median values of biomarkers were higher among blacks versus whites (all P < 0.001). Relative risks for each biomarker with incident CVD and ESRD, and odds ratios for each biomarker with prevalent retinopathy, were similar by race (all P values for interaction by race >0.10). CONCLUSIONS: The prognostic value of HbA1c, fructosamine, glycated albumin, and 1,5-AG with incident CVD, incident ESRD, and prevalent retinopathy were similar by race. Our results support similar interpretation of HbA1c and nontraditional biomarkers of hyperglycemia among black and whites with respect to long-term complications.
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A study among races showed that all measures of glycemia, including HbA1c, fructosamine, and glycated albumin, were on average higher among Black participants compared with White participants, and that the measures were similarly associated with risk of nephropathy, retinopathy, and cardiovascular disease in the different races.
“In addition, a study among races showed that all measures of glycemia, including HbA 1c , fructosamine, and glycated albumin, were on average higher among Black participants compared with White participants, and that the measures were similarly associated with risk of nephropathy, retinopathy, and cardiovascular disease (CVD) in the different races (340).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [340]
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Experimental — accuracy not yet measuredThe consistency of glycemic measurements within races and the similar relationship of each glycemic measurement with complications in Black compared with White populations suggests that higher HbA1c measurements in Black populations reflects, at least in part, higher glycemic exposure and not just a difference in the relationship between mean glycemia and HbA1c levels.
“The consistency of glycemic measurements within races and the similar relationship of each glycemic measurement with complications in Black compared with White populations suggests that higher HbA 1c measurements in Black populations reflects, at least in part, higher glycemic exposure and not just a difference in the relationship between mean glycemia and HbA 1c levels.”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [340]
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- Authors
- Parrinello, C. M., Sharrett, A. R., Maruthur, N. M., Bergenstal, R. M., Grams, M. E., Coresh, J., & Selvin, E.
- Affiliations
- Johns Hopkins University (US)
- Park Nicollet Health Services (US)
- Corresponding author
- Selvin, Elizabeth
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2015-12-17
- Volume
- 39
- Issue
- 4
- Pages
- 589-595
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC4806772
- OpenAlex
- W2206827451
- Semantic Scholar
- 1c0bb8740c968bd7c7430ed8e64616e2c02bb18d
- Cited by
- 29
- References
- 47
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2023: 2 · 2021: 1 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 2
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH/NHLBI (T32HL007024)
- NIH/NIDDK (R01DK089174, K24DK106414, HHSN268201100005C)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Keywords
- racial differences, black-white disparities, HbA1c, fructosamine, glycated albumin, 1,5-anhydroglucitol, cardiovascular disease, end-stage renal disease, diabetic retinopathy, diabetes complications, prognostic value, Atherosclerosis Risk in Communities Study
- MeSH terms
- Glycated Serum Albumin, Blood Glucose, Cardiovascular Diseases, Deoxyglucose, Diabetes Mellitus, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hyperglycemia, Kidney Failure, Chronic, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Serum Albumin, Biomarkers, Body Mass Index, Incidence, Proportional Hazards Models, Glycation End Products, Advanced, Fructosamine, Racial Groups
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