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Concordance between...
Concordance between fasting plasma glucose and HbA1c in the diagnosis of diabetes in black South African adults: A cross-sectional study
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- Wade, Alisha N. (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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- Crowther, Nigel J. (författare)
- Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
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- Abrahams-Gessel, Shafika (författare)
- Centre for Health Decision Science, Harvard University T H Chan School of Public Health, MA, Boston, United States
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- Berkman, Lisa (författare)
- Harvard Centre for Population and Development Studies, Harvard University T H Chan School of Public Health, MA, Boston, United States
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- George, Jaya A. (författare)
- Department of Chemical Pathology, University of the Witwatersrand, Johannesburg, South Africa; Department of Chemical Pathology, National Health Laboratory Service, Johannesburg, South Africa
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- Gómez-Olivé, F. Xavier (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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- Manne-Goehler, Jennifer (författare)
- Division of Infectious Diseases, Massachusetts General Hospital, MA, Boston, United States
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- Salomon, Joshua A. (författare)
- Centre for Health Policy, Stanford University, CA, Stanford, United States
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- Wagner, Ryan G. (författare)
- MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
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- Gaziano, Thomas A. (författare)
- Centre for Health Decision Science, Harvard University T H Chan School of Public Health, MA, Boston, United States; Division of Cardiovascular Medicine, Brigham and Women’s Hospital, MA, Boston, United States
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- Tollman, Stephen M. (författare)
- Umeå universitet,Institutionen för epidemiologi och global hälsa,Institutionen för folkhälsa och klinisk medicin,MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana
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- Cappola, Anne R. (författare)
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, PA, Philadelphia, United States
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(creator_code:org_t)
- 2021-06-17
- 2021
- Engelska.
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:6
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://bmjopen.bmj....
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objectives: We investigated concordance between haemoglobin A1c (HbA1c)-defined diabetes and fasting plasma glucose (FPG)-defined diabetes in a black South African population with a high prevalence of obesity.Design: Cross-sectional study.Setting: Rural South African population-based cohort.Participants: 765 black individuals aged 40–70 years and with no history of diabetes.Primary and secondary outcome measures: The primary outcome measure was concordance between HbA1c-defined diabetes and FPG-defined diabetes. Secondary outcome measures were differences in anthropometric characteristics, fat distribution and insulin resistance (measured using Homoeostatic Model Assessment of Insulin Resistance (HOMA-IR)) between those with concordant and discordant HbA1c/FPG classifications and predictors of HbA1c variance.Results: The prevalence of HbA1c-defined diabetes was four times the prevalence of FPG-defined diabetes (17.5% vs 4.2%). Classification was discordant in 15.7% of participants, with 111 individuals (14.5%) having HbA1c-only diabetes (kappa 0.23; 95% CI 0.14 to 0.31). Median body mass index, waist and hip circumference, waist-to-hip ratio, subcutaneous adipose tissue and HOMA-IR in participants with HbA1c-only diabetes were similar to those in participants who were normoglycaemic by both biomarkers and significantly lower than in participants with diabetes by both biomarkers (p<0.05). HOMA-IR and fat distribution explained additional HbA1c variance beyond glucose and age only in women.Conclusions: Concordance was poor between HbA1c and FPG in diagnosis of diabetes in black South Africans, and participants with HbA1c-only diabetes phenotypically resembled normoglycaemic participants. Further work is necessary to determine which of these parameters better predicts diabetes-related morbidities in this population and whether a population-specific HbA1c threshold is necessary.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- epidemiology
- general diabetes
- international health services
- public health
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Wade, Alisha N.
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Crowther, Nigel ...
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Abrahams-Gessel, ...
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Berkman, Lisa
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George, Jaya A.
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Gómez-Olivé, F. ...
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Manne-Goehler, J ...
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Salomon, Joshua ...
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Wagner, Ryan G.
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Gaziano, Thomas ...
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Tollman, Stephen ...
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Cappola, Anne R.
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