[Distribution of glycosylated hemoglobin (HbA1) in an internal medicine service in Gabon].
Measurement of glycated hemoglobin (HbA1) concentration is commonly recommended to monitor diabetes, but the relevance of this parameter in some black African populations is questionable. To assess the suitability of this test and study factors affecting HbA1 concentration, we measured HbA1 concentration in 297 consecutive patients (185 men and 112 women) hospitalized in the Internal Medicine Department of the Libreville Hospital Center in Gabon. Distribution of HbA1 was asymmetric with a median at 7.2% (IC95: 6.8-7.6%). Metabolic abnormalities associated with diabetes, renal insufficiency, hyper-bilirubinemia and hypertriglyceridemia were not preferentially correlated with a distribution of HbA1 concentration above the normal threshold of 7.5 %. Elevated concentration were observed in 81 patients presenting no abnormalities. These findings was not due ro technical problems, alcohol abuse, or aspirin intake or to congenital hematologic abnormalities that have been documented in Gabon. On the other hand, an increase in glycation secondary to latent infection which is frequent in tropical areas may partially explain these findings. Regardless of the explanation, HbA1 appears to be unsuitable for monitoring diabetes in this population group.
Perret J-L
Service de Médecine A du Centre Hospitalier de Libreville.
Ngou-Milama
E
E
Nguemby-Mbina
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000097:blood* / Q000208:ethnology / Q000235:genetics; D005260:Female; D005681:Gabon; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008659:Metabolic Diseases / Q000097:blood* / Q000208:ethnology / Q000235:genetics; D008875:Middle Aged; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D006442:Glycated Hemoglobin