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Haemoglobin A 1c 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)
Author(s) -
Shultis W. A.,
Leary S. D.,
Ness A. R.,
Scott J.,
Martin R. M.,
Whincup P. H.,
Smith G Davey
Publication year - 2006
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2006.01990.x
Subject(s) - medicine , insulin resistance , body mass index , endocrinology , type 2 diabetes , insulin , diabetes mellitus , confounding , type 1 diabetes
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 (β = 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 (β =−0.02%/unit, P = 0.004), body mass index sd score (β = −0.02%/unit, P = 0.002), and total body fat (β = −0.003%/kg, P = 0.06) and lean mass (β = −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.