title: Ethnicity modifies the relation between fasting plasma glucose and HbA1c in Indians, Malays and Chinese.
abstract: OBJECTIVE
  To study whether HbA(1c) , and its relationship with fasting plasma glucose, was significantly different among Chinese, Malays and Indians in Singapore.
  
  
  METHODS
  A sample of 3895 individuals without known diabetes underwent detailed interview and health examination, including anthropometric and biochemical evaluation, between 2004 and 2007. Pearson's correlation, analysis of variance and multiple linear regression analyses were used to examine the influence of ethnicity on HbA(1c) .
  
  
  RESULTS
  As fasting plasma glucose increased, HbA(1c) increased more in Malays and Indians compared with Chinese after adjustment for age, gender, waist circumference, serum cholesterol, serum triglyceride and homeostasis model assessment of insulin resistance (P-interaction < 0.001). This translates to an HbA(1c) difference of 1.1 mmol/mol (0.1%, Indians vs. Chinese), and 0.9 mmol/mol (0.08%, Malays vs. Chinese) at fasting plasma glucose 5.6 mmol/l (the American Diabetes Association criterion for impaired fasting glycaemia); and 2.1 mmol/mol (0.19%, Indians vs. Chinese) and 2.6 mmol/mol (0.24%, Malays vs. Chinese) at fasting plasma glucose 7.0 mmol/l, the diagnostic criterion for diabetes mellitus.
  
  
  CONCLUSIONS
  Using HbA(1c) in place of fasting plasma glucose will reclassify different proportions of the population in different ethnic groups. This may have implications in interpretation of HbA(1c) results across ethnic groups and the use of HbA(1c) for diagnosing diabetes mellitus.
authors.affiliation: Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: K
authors.initials: K
authors.lastname: Venkataraman
authors.forename: S L
authors.initials: SL
authors.lastname: Kao
authors.forename: A C
authors.initials: AC
authors.lastname: Thai
authors.forename: A
authors.initials: A
authors.lastname: Salim
authors.forename: J J M
authors.initials: JJ
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Heng
authors.forename: E S
authors.initials: ES
authors.lastname: Tai
authors.forename: E Y H
authors.initials: EY
authors.lastname: Khoo
mesh_terms: D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D002681:China / Q000208:ethnology; D002784:Cholesterol / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000208:ethnology; D005215:Fasting / Q000378:metabolism*; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D007333:Insulin Resistance; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference; D044465:White People
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002784:Cholesterol