Inter-university Laboratory of Biology of Motor Function EA7424, « Vascular Biology and the Red Blood Cell » team, Claude Bernard University Lyon 1, University de Lyon 1, Villeurbanne, France.
Laboratory of Excellence GR-Ex, Paris, France.
PLoS One. 2019 Feb 15;14(2):e0212552. doi: 10.1371/journal.pone.0212552. eCollection 2019.
Fasting glucose (FG) and glycated hemoglobin A1c (HbA1c) perform sub-optimally in people of African origin, especially in individuals with sickle-cell trait (SCT). The purpose of this study was to compare the relationships between HbA1c, FG, and fructosamine in individuals from Senegal with and without SCT. HbA1c, FG, and fructosamine were measured in 203 adults from Senegal (100 control: 45 with type 2 diabetes (T2D); 103 SCT: 51 with T2D). Significant, positive correlations were observed between HbA1c and FG, fructosamine and FG, and fructosamine and HbA1c in both groups. The limits of agreement were inappropriately large in both groups for the Bland-Altman plots of HbA1c and FG (control: -95.97 to 83.97%; SCT: -115.9 to 91.52%), fructosamine and FG (control: -100.6 to 99.89%; SCT: -105.6 to 100.6%), and fructosamine and HbA1c (control: -52.03 to 38.98%; SCT: -88.04 to 71.41%). In both groups, the greatest proportion of subjects were considered above the clinical cut-point for hyperglycemia when fructosamine was used as the criterion (control: 33%; SCT: 44.6%), and the lowest percentage of subjects were classified as over the clinical cut-point when HbA1c was used as the criterion (control: 21%; SCT: 27.7%).Substantial disparities between HbA1c, FG, and fructosamine were observed in both groups, and these differences were exaggerated in the SCT group. Therefore, these three biomarkers should not be considered to be interchangeable measures of glycemic control. These biomarkers should be used thoughtfully, and special care should be taken when using them in individuals with SCT.
空腹血糖（FG）和糖化血红蛋白 A1c（HbA1c）在非裔人群中的表现并不理想，尤其是在镰状细胞特征（SCT）个体中。本研究旨在比较塞内加尔具有和不具有 SCT 的个体之间 HbA1c、FG 和果糖胺之间的关系。在塞内加尔的 203 名成年人中测量了 HbA1c、FG 和果糖胺（100 名对照：45 名 2 型糖尿病（T2D）；103 名 SCT：51 名 T2D）。在两组中，均观察到 HbA1c 与 FG、果糖胺与 FG 以及果糖胺与 HbA1c 之间存在显著正相关。对于 HbA1c 和 FG 的 Bland-Altman 图（对照组：-95.97 至 83.97%；SCT：-115.9 至 91.52%）、果糖胺和 FG（对照组：-100.6 至 99.89%；SCT：-105.6 至 100.6%）以及果糖胺和 HbA1c（对照组：-52.03 至 38.98%；SCT：-88.04 至 71.41%），两组的一致性界限都过大。在两组中，当果糖胺作为标准时，使用最大比例的患者被认为高于高血糖的临床切点（对照组：33%；SCT：44.6%），而当 HbA1c 作为标准时，使用最低比例的患者被归类为高于临床切点（对照组：21%；SCT：27.7%）。在两组中，均观察到 HbA1c、FG 和果糖胺之间存在明显差异，而在 SCT 组中，这些差异被夸大了。因此，这三种生物标志物不应被视为血糖控制的可互换衡量标准。这些生物标志物应谨慎使用，在具有 SCT 的个体中使用时应特别小心。
