Abstract
IntroductionDiagnosis 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.Materials and methodsThis 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.ResultsROC 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.ConclusionsMeasurement of glycated nail proteins could be used to diagnose and monitor diabetes mellitus in sub-Saharan Africa.
Highlights
Diagnosis and monitoring of diabetes mellitus in sub-Saharan Africa, based on blood analyses, are hampered by infrastructural and cultural reasons
Screening and monitoring of diabetes mellitus is of utmost importance as it is associated with an important morbidity and mortality, as well as with a negative influence on the local economies
The first aim of the study was to evaluate the diagnostic accuracy of measuring the concentration of glycated nail proteins for diabetes mellitus in a subSaharan African population
Summary
Diagnosis and monitoring of diabetes mellitus in sub-Saharan Africa, based on blood analyses, are hampered by infrastructural and cultural reasons. 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. ©Copyright by Croatian Society of Medical Biochemistry and Laboratory Medicine Glycated keratins and diabetes regions, like sub-Saharan Africa, were in people under 60 years old [3]
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