Predictors of Hemoglobin A1c in a National Sample of Nondiabetic Children: The Third National Health and Nutrition Examination Survey, 1988-1994

Hemoglobin A1c (HbA1c) is related to glucose metabolism in diabetic and nondiabetic persons. Analysis of factors related to HbA1c may help researchers to better identify children with an increased likelihood of developing type 2 diabetes mellitus. In this study, the authors investigated predictors of HbA1c percentage among 1,700 Mexican-American, 1,787 African-American, and 1,441 non-Hispanic White young people aged 4-17.0 years who were free of diabetes and were examined in the Third National Health and Nutrition Examination Survey (1988-1994). HbA1c was positively related to age and body mass index (p = 0.065 and p = 0.008, respectively) and negatively related to an indicator of socioeconomic status, the poverty income ratio (p = 0.008). African Americans and Mexican Americans had higher mean HbA1c percentages than non-Hispanic Whites after data were controlled for age, sex, body mass index, maternal body mass index, and poverty income ratio. While some inconsistencies emerged, HbA1c was generally associated with other known risk factors for type 2 diabetes in young people. This report provides representative data on HbA1c percentage among nondiabetic children. However, further investigation will be needed to better understand the utility of HbA1c and its relation to type 2 diabetes in youth.