Prevalence of diabetes mellitus and correlation of urinary transforming growth factor-beta1 with blood hemoglobin A1C in the Atascosa Diabetes Study.

INTRODUCTION This study was conducted to determine the prevalence of type 2 diabetes and prediabetes in the Atascosa Diabetes Study sample and to ascertain the relationship between urinary transforming growth factor-beta1 (TGF-beta1) and blood hemoglobin (Hgb) A1C. METHODS Subjects (N = 526) classified as adjusted normal, at risk, prediabetes, and diabetes mellitus were given a one-hour and two-hour postprandial glucose (PPG) test. Morning urine samples were collected to test for a correlation of TGF-beta1 with blood HgbA1C. RESULTS Of the subjects, 14.3% had diabetes, 31.6% had prediabetes, 7.9% were at risk, and 46.2% were adjusted normal. Sensitivity and specificity for one-hour PPG for prediabetes and diabetes were significant, with an efficiency of 80.2%-90.9% and a likelihood ratio of 4.7-10.2. Receiver operating characteristic analysis resulted in an area under the curve of .880 +/- .016 for one hour to prediabetes and diabetes and .960 +/- .016 for one hour to diabetes. Prediabetes was 1.07 times more prevalent in Hispanics, but diabetes was 1.65 times greater in Whites. Urinary TGF-beta1 was more than fivefold higher in poorly controlled versus controlled diabetic or normal subjects and had a significant positive correlation with HgbA1C. CONCLUSIONS The percentage of subjects with type 2 diabetes was 1.64 times higher than the national average. Prevalence of prediabetes was equivalent in Hispanics and Whites, and the reversal for diabetes might reflect higher mortality rate from diabetes in Hispanics in Atascosa County. Use of one-hour PPG and urine markers for early kidney involvement could improve this disparity in such high-risk populations.