Wu Wen-Chih, Lacy Mary E, Correa Adolfo, Carnethon Mercedes, Reiner Alexander P, Eaton Charles B, Wellenius Gregory A
Division of Cardiology, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA.
Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
J Diabetes Treat. 2018;3(4). Epub 2018 Dec 3.
1.1.It was reported that Hemoglobin A1c (HbA1c) values of African-Americans (AAs) were on average higher than whites whereas AAs with Sickle-Cell-Trait (SCT) had lower HbA1c values compared to AAs without SCT despite controlling for average glycaemia. We evaluated the HbA1c-glucose relationship between AAs with and without SCT, and whites using data from two cohort studies.
1.2.We pooled data from Coronary-Artery-Risk-Development-Study-in-Young-Adults (CARDIA, n= 5,115, 2005-2011) and the Jackson-Heart-Study (JHS, n=5,301, 2000-2013). Whole exome sequencing in JHS and TaqMan-SNP-Genotyping Assays in CARDIA determined the SCT status in AAs. HbA1c was measured by two NGSP-certified assays without reportedly clinically significant interference from hemoglobin S. Participants without data on SCT or with hemoglobin SS, CC or AC were excluded, resulting in 6,623 participants (n=3,575 from CARDIA and n=3,048 from JHS). Generalized-estimating-equations estimated the cross-sectional association between fasting glucose and HbA1c(outcome) amongst whites, AAs with SCT, and AAs without SCT controlling for clinical-demographic factors.
1.3.Our analyses included 2,003 whites, 4,253 AAs without SCT and 367 AAs with SCT. AAs with and without SCT had similar clinical-demographic characteristics, whereas whites have lower fasting- and 2-hour-glucose values than AAs. Despite higher fasting-glucose values in AAs with SCT versus whites, their HbA1c values were similar (p=0.39). In the subset with 2-hour-glucose values, HbA1c values in AAs with SCT were lower than whites (p=0.007) despite higher 2-hour-glucose values.
1.4.AAs with SCT have at least similar, if not lower, levels of mean HbA1c values than whites despite higher levels of glycaemia. Future research is warranted to assess whether these findings translate to clinical outcomes.
1.1. 据报道，非裔美国人（AA）的糖化血红蛋白（HbA1c）值平均高于白人，而具有镰状细胞性状（SCT）的非裔美国人与没有SCT的非裔美国人相比，尽管控制了平均血糖水平，但其HbA1c值更低。我们使用两项队列研究的数据评估了有和没有SCT的非裔美国人以及白人之间HbA1c与血糖的关系。
1.2. 我们汇总了青年成年人冠状动脉风险发展研究（CARDIA，n = 5115，2005 - 2011年）和杰克逊心脏研究（JHS，n = 5301，2000 - 2013年）的数据。JHS中的全外显子组测序和CARDIA中的TaqMan单核苷酸多态性基因分型检测确定了非裔美国人的SCT状态。HbA1c通过两种经NGSP认证的检测方法进行测量，据报道血红蛋白S对其没有临床显著干扰。排除没有SCT数据或患有血红蛋白SS、CC或AC的参与者，最终纳入6623名参与者（CARDIA组3575名，JHS组3048名）。广义估计方程估计了白人、有SCT的非裔美国人和没有SCT的非裔美国人在控制临床人口统计学因素的情况下空腹血糖与HbA1c（结果）之间的横断面关联。
1.3. 我们的分析纳入了2003名白人、4253名没有SCT的非裔美国人和367名有SCT的非裔美国人。有和没有SCT的非裔美国人具有相似的临床人口统计学特征，而白人的空腹血糖和2小时血糖值低于非裔美国人。尽管有SCT的非裔美国人的空腹血糖值高于白人，但其HbA1c值相似（p = 0.39）。在有2小时血糖值的亚组中，有SCT的非裔美国人的HbA1c值低于白人（p = 0.007），尽管其2小时血糖值更高。
1.4. 尽管血糖水平较高，但有SCT的非裔美国人的平均HbA1c值至少与白人相似，甚至可能更低。有必要进行进一步研究以评估这些发现是否转化为临床结果。
