Racial and ethnic differences in the relationship between HbA1c and blood glucose: implications for the diagnosis of diabetes.

摘要: Hemoglobin A1c (HbA1c) is widely used as an index of mean glycemia in diabetes, a measure risk for the development diabetic complications, and quality diabetes care. In 2010, American Diabetes Association recommended that HbA1c tests, performed laboratory using method certified by National Glycohemoglobin Standardization Program, be diagnosis diabetes. Although has number advantages compared to traditional glucose criteria, it disadvantages. Hemoglobinopathies, thalassemia syndromes, factors impact red blood cell survival age, uremia, hyperbilirubinemia, iron deficiency may alter test results average glycemia. Recently, racial ethnic differences relationship between have also been described. reasons remain unknown, such survival, extracellular-intracellular balance, nonglycemic genetic determinants hemoglobin glycation are being explored contributors. Until these more clearly defined, reliance on sole, or even preferred, criterion creates potential systematic error misclassification. must thoughtfully combination with criteria when screening diagnosing