title: Glycated nail proteins as a new biomarker in management of the South Kivu Congolese diabetics.
abstract: BACKGROUND
  Diagnosis and monitoring of diabetes mellitus in sub-Saharan Africa, based on blood analyses, are hampered by infrastructural and cultural reasons. The first aim of this study was to evaluate the diagnostic accuracy of glycated nail proteins for diabetes mellitus. The second aim was to compare the course of short- and long-term glycemic biomarkers after 6 months of antidiabetic treatment. These objectives should support our hypothesis that glycated nail proteins could be used as an alternative glycemic biomarker.
  
  
  METHODS
  This case-control study consisted of 163 black diabetics and 67 non-diabetics of the South Kivu (Democratic Republic of Congo). Diagnostic accuracy of glycated nail proteins was evaluated using ROC curve analysis. At the start of the study, glycated nail protein concentrations were compared between diabetics and non-diabetics, using a nitro blue tetrazolium (NBT) colorimetric method. In a subgroup of 30 diabetics, concentrations of glycated nail proteins, fasting glucose (Accu-Chek® Aviva), serum fructosamine (NBT) and HbA1c (DCA-2000+®) were measured at start and after 6 months.
  
  
  RESULTS
  ROC analysis yielded an AUC of 0.71 (95% confidence interval (CI): 0.65-0.76) and a cut-off point of 3.83 μmol/g nail. Concentration of glycated nail proteins was significantly higher (P<0.001) in diabetics in comparison with non-diabetics. After 6 months of antidiabetic treatment, a significant drop in the fasting glucose concentration (P=0.017) and concentration of glycated nail proteins (P=0.008) was observed in contrast to serum fructosamine and HbA1c.
  
  
  CONCLUSIONS
  Measurement of glycated nail proteins could be used to diagnose and monitor diabetes mellitus in sub-Saharan Africa.
authors.affiliation: Observatory NCDs VLIR-UOS/UBC, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo ; Division of Endocrinology and Diabetology, Department of Internal Medicine, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo.
authors.forename: Philippe B
authors.initials: PB
authors.lastname: Katchunga
authors.affiliation: Regional School of Public Health (ERSP), Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo.
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Mirindi
authors.affiliation: Observatory NCDs VLIR-UOS/UBC, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo ; Department of Clinical Biology, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo.
authors.forename: Antoine S
authors.initials: AS
authors.lastname: Kishabongo
authors.affiliation: Observatory NCDs VLIR-UOS/UBC, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo ; Division of Endocrinology and Diabetology, Department of Internal Medicine, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Cikomola
authors.affiliation: Observatory NCDs VLIR-UOS/UBC, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo ; Department of Clinical Biology, Reference Provincial General Hospital of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo.
authors.forename: Socrate
authors.initials: S
authors.lastname: Bwanamdogo
authors.affiliation: Observatory NCDs VLIR-UOS/UBC, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo ; Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Philippé
authors.affiliation: Department of Nephrology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Marijn M
authors.initials: MM
authors.lastname: Speeckaert
authors.affiliation: Observatory NCDs VLIR-UOS/UBC, Faculty of Medicine of the Catholic University of Bukavu, Bukavu, South-Kivu Province, Democratic Republic of Congo ; Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium.
authors.forename: Joris R
authors.initials: JR
authors.lastname: Delanghe
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D003124:Colorimetry / Q000379:methods*; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D003906:Developing Countries; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000378:metabolism*; D019468:Disease Management; D016903:Drug Monitoring; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced / Q000032:analysis*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000737:chemistry*; D012372:ROC Curve; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents
keywords: diabetes mellitus; fasting glucose concentration; fructosamine; hemoglobin A1c protein; nails; sub-Saharan Africa