Haemoglobin A1c is Not a Surrogate for Glucose and Insulin Measures for Investigating the Early Life and Childhood Determinants of Insulin Resistance and Type 2 Diabetes in Healthy Children. An Analysis from the Avon Longitudinal Study of Parents and Children (Alspac).
From: Department of Social Medicine, University of Bristol, UK. shultisw@mail.nih.gov
Diabetic medicine : a journal of the British Diabetic Association
- Publish Date: Dec 2006
- ISSN: 0742-3071
- Volume: 23
- Issue: 12
- Pages: 1357-63
- Medium: Print
- Language: English
- Citation (JAMA): Shultis W A, Leary S D, Ness A R, et al. Haemoglobin A1c is Not a Surrogate for Glucose and Insulin Measures for Investigating the Early Life and Childhood Determinants of Insulin Resistance and Type 2 Diabetes in Healthy Children. An Analysis from the Avon Longitudinal Study of Parents and Children (Alspac).. Diabet. Med. Dec 2006;23:1357-63
Abstract
AIMS: Research into early life and childhood determinants of insulin resistance and Type 2 diabetes are complicated by requirements for fasting blood samples and glucose tolerance tests. We investigated haemoglobin A(1c) (HbA(1c)), a marker of glycaemia measured in non-fasting blood, as an alternative. METHODS: HbA(1c) was measured in 1645 children aged 9-11 years without diabetes from the Avon Longitudinal Study of Parents and Children. Thirty-nine children had two HbA(1c) measurements. Data on parental, child and potential confounding factors were collected prospectively from questionnaires, medical records and direct examination. Data from a shortened 30-min oral glucose tolerance test were available for 431 children at age 8 years. Body composition was measured by dual-energy X-ray absorptiometry. RESULTS: Mean (sd) HbA(1c) was 4.91(0.29)%. HbA(1c) increased with age and was higher in boys compared with girls, non-white compared with white children, and in children with anaemia. Mean difference between repeated HbA(1c) measurements was 0.01%. HbA(1c) was weakly positively associated with fasting glucose (beta = 0.066%/mmol/l, P = 0.05), but was not associated with 30-min glucose, fasting or 30-min insulin, or homeostasis model assessment-insulin resistance. HbA(1c) was weakly inversely associated with weight sd score (beta =-0.02%/unit, P = 0.004), body mass index sd score (beta = -0.02%/unit, P = 0.002), and total body fat (beta = -0.003%/kg, P = 0.06) and lean mass (beta = -0.011%/kg, P = 0.01), but was not associated with birthweight or breastfeeding. CONCLUSIONS: HbA(1c) is not a good marker of fasting or post-load glucose and insulin measures in healthy children, and is not a viable alternative to these measures for investigating the determinants of insulin resistance and Type 2 diabetes in children.
Mesh Headings (Keywords): Biological Markers, Blood Glucose, Child, Diabetes Mellitus, Type 2, Fasting, Female, Glucose Tolerance Test, Hemoglobin A, Glycosylated, Humans, Insulin, Insulin Resistance, Longitudinal Studies, Male
Check for Full Text / PubMed Unique Identifier (PMID): 17116188
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