Proceedings of The 3rd Africa Diabetes Congress, Yaounde, Cameroon (Yaounde, 2017)

Oral presentation

Sickle cell trait may alter the relationship between A1C and glycemia: a preliminary report from the Africans in America cohort

Cite this: Pan African Medical Journal - Conference Proceedings. Aug 2017; 2(2): 4. doi:10.11604/pamj.cp.2017.2.4.43

Submitted: 23 Aug 17   Accepted: 23 Aug 17   Published: 23 Aug 17

Key words: SCT, A1C, glycemia, Africans

© Jean Nepo Utumatwishima et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.proceedings.panafrican-med-journal.com/conferences/2017/2/4/abstract

Corresponding author: Jean Nepo Utumatwishima, National Institutes of Health, Bethesda, Maryland, USA (jean.utumatwishima@nih.gov)

This abstract is published as part of the proceedings of The 3rd Africa Diabetes Congress, Yaounde, Cameroon(CAMEROON, )

Sickle cell trait may alter the relationship between A1C and glycemia: a preliminary report from the Africans in America cohort

Jean Nepo Utumatwishima1,&, David Sacks1, Anne Sumner1

 

1National Institutes of Health, Bethesda, Maryland, USA

 

 

&Corresponding author
Jean Nepo Utumatwishima, National Institutes of Health, Bethesda, Maryland, USA

 

 

Abstract

Introduction: diabetes in Africa is reaching epidemic proportions. HbA1C, a form of glycated hemoglobin A (HbA), is used to diagnose and monitor diabetes. However, with sickle cell trait, hemoglobin type is HbAS rather than HbAA and HbA levels are 55% to 70% of normal. As the prevalence of HbAS is high in Africa, clarity on whether HbAS modifies the relationship between HbA1C and glycemia is necessary. Our goal was to match by age, sex and African region of origin, 48 African immigrants with HbAS to 48 African immigrants with HbAA, perform OGTT and compare the relationship of HbA1C to three glycemic measures: fasting plasma glucose (FPG), 2h glucose and area-under-curve for glucose (AUC-glucose).

 

Methods: participants (67% male, age 40±11y (mean±SD), range 22-61y) were born in Africa (West 56%, Central 31%, East 13%), lived in Washington, DC and enrolled in the Africans in America cohort. OGTT were performed with glucose concentrations determined at 0, 0.5, 1h and 2h. On the same day hemoglobin electrophoresis and HbA1C levels were determined.

 

Results: HbA1Clevels in the HbAS and HbAA groups were: 5.6±0.5 vs. 5.4±0.4, P = 0.02. In the HbAS and HbAA groups, the respective correlations between HbA1c and FPG were: 0.56 vs. 0.12, P = 0.02. The correlations between HbA1C and 2h glucose in the two groups were: 0.59 vs. -0.11, P < 0.01. The correlations between HbA1C and AUC-glucose in each group were: 0.60 vs. -0.03, P < 0.01.

 

Conclusion: the significant difference in correlation between HbA1C and each glycemic measure, suggests that the relationship between HbA1C and glucose concentration varies according to HbAS status. Therefore, the efficacy of HbA1C and even diagnostic thresholds for HbA1C may need to be sickle cell trait-specific. Due to the magnitude of the diabetes epidemic and the high prevalence of HbAS in Africa, these findings need additional exploration in a larger cohort.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The 3rd Africa Diabetes Congress, Yaounde, Cameroon (Yaounde)

Country: CAMEROON

Dates: 19 Apr 17 - 22 Apr 17

Venue: Yaounde Congress Hall

Organizers: Africa Diabetes Congress Limited

Secretariat: secretariat@africadiabetescongress.com

Contact person: Prof. Jean Claude Mbanya (jcmbanya@yahoo.co.uk)