title: Detecting prediabetes among Hispanics/Latinos from diverse heritage groups: Does the test matter? Findings from the Hispanic Community Health Study/Study of Latinos.
abstract: The objectives of this analysis were to compare the ability of fasting plasma glucose (FPG), post oral load plasma glucose (2hPG), and hemoglobin A1c(HbA1c) to identify U.S. Hispanic/Latino individuals with prediabetes, and to assess its cardiovascular risk factor correlates. This is a cross-sectional analysis of baseline data from 15,507 adults without self-reported diabetes mellitus from six Hispanic/Latino heritage groups, enrolled in the Hispanic Community Health Study/Study of Latinos, which takes place in four U.S. communities. The prevalence of prediabetes was determined according to individual or combinations of ADA-defined cut points: FPG=5.6-7.0mmol/L, 2hPG=7.8-11.1mmol/L, and HbA1c=5.7%-6.4% (39-46mmol/mol). The sensitivity of these criteria to detect prediabetes was estimated. The prevalence ratios (PRs) for selected cardiovascular risk factors were compared among alternative categories of prediabetes versus normoglycemia [FPG<5.6mmol/L and 2hPG<7.8mmol/L and HbA1c<5.7% (39mmol/mol)]. Approximately 36% of individuals met any of the ADA prediabetes criteria. Using 2hPG as the gold standard, the sensitivity of FPG was 40.1%, HbA1cwas 45.6%, and that of HbA1c+FPG was 62.2%. The number of significant PRs for cardiovascular risk factors was higher among individuals with isolated 2hPG=7.8-11.1mmol/L, FPG=5.6-7.0mmol/L+HbA1c=5.7%-6.4%, or those who met the three prediabetes criteria. Assessing FPG, HbA1c, and cardiovascular risk factors in Hispanics/Latinos at risk might enhance the early prevention of diabetes mellitus and cardiovascular complications in this young and growing population, independent of their heritage group.
authors.affiliation: National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Room 10188, Bethesda, MD 20892, United States. Electronic address: avilessantal@nhlbi.nih.gov.
authors.forename: M Larissa
authors.initials: ML
authors.lastname: Avilés-Santa
authors.affiliation: University of Puerto Rico Graduate School of Public Health, Department of Biostatistics and Epidemiology, Medical Sciences Campus, PO Box 365067, San Juan 00936-5067, Puerto Rico. Electronic address: cynthia.perez1@upr.edu.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.affiliation: University of Miami, 5665 Ponce de Leon Boulevard, Room 408, PO Box 248185, Coral Gables, FL 33124, United States. Electronic address: nschneid@miami.edu.
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy Boulevard, Bethesda, MD 20982, United States. Electronic address: savagep@niddk.nih.gov.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Savage
authors.affiliation: Albert Einstein College of Medicine, Belfer Building, Room 1306C, 1300 Morris Park Ave, Bronx, NY 10461, United States. Electronic address: robert.kaplan@einstein.yu.edu.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kaplan
authors.affiliation: University of North Carolina at Chapel Hill, 137 East Franklin Street, Suite 203, Mail Station UNC staff use CB803, Chapel Hill, NC 27514, United States. Electronic address: tengunc@email.unc.edu.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Teng
authors.affiliation: University of Puerto Rico Graduate School of Public Health, Department of Biostatistics and Epidemiology, Medical Sciences Campus, PO Box 365067, San Juan 00936-5067, Puerto Rico. Electronic address: erick.suarez@upr.edu.
authors.forename: Erick L
authors.initials: EL
authors.lastname: Suárez
authors.affiliation: University of North Carolina at Chapel Hill, 137 East Franklin Street, Suite 203, Mail Station UNC staff use CB803, Chapel Hill, NC 27514, United States. Electronic address: cai@bios.unc.edu.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cai
authors.affiliation: Northwestern University, Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60611, United States. Electronic address: a-giachello@northwestern.edu.
authors.forename: Aida L
authors.initials: AL
authors.lastname: Giachello
authors.affiliation: Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, 450 Fourth Ave, Suite 400, Chula Vista, CA 91910, United States. Electronic address: gtalavera@mail.sdsu.edu.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Talavera
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy Boulevard, Bethesda, MD 20982, United States. Electronic address: CowieC@Extra.niddk.nih.gov.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Cowie
mesh_terms: D003430:Cross-Sectional Studies; D003469:Culture; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005951:Glucose Tolerance Test / Q000379:methods*; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension; D011236:Prediabetic State / Q000097:blood*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin
keywords: Hispanics; Hypertension; LDL cholesterol; Latinos; Obesity; Prediabetic state; Triglycerides