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Distribution of HbA_1c Levels For Children and Young Adults in the U.S.

Third National Health and Nutrition Examination Survey

¹ Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
² National Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, Georgia

OBJECTIVE—To describe the distribution of HbA_1c levels among children and young adults in the U.S. and to evaluate the effects of age, sex, race/ethnicity, socioeconomic status, parental history of diabetes, overweight, and serum glucose on HbA_1c levels.

RESEARCH DESIGN AND METHODS—We analyzed HbA_1c data from the Third National Health and Nutrition Examination Survey, 1988–1994, for 7,968 participants aged 5–24 years who had not been treated for diabetes. After adjusting for the complex sample design, we compared the distributions of HbA_1c in subgroups and developed multiple linear regression models to examine factors associated with HbA_1c.

RESULTS—Mean HbA_1c level was 4.99% (SD 0.50%) and varied from 4.93% (95% CI ±0.04) in non-Hispanic whites to 5.05% (±0.02) in Mexican-Americans to 5.17% (±0.02) in non-Hispanic blacks. There were very small differences among subgroups. Within each age- group, among men and women, among overweight and nonoverweight subjects, and at any level of education, mean HbA_1c levels were higher in non-Hispanic blacks than in non-Hispanic whites. After adjusting for confounders, HbA_1c levels for non-Hispanic blacks (5.15%, 95% CI ±0.04) and Mexican-Americans (5.01%, ±0.04) were higher than those for non-Hispanic whites (4.93%, ±0.04).

CONCLUSIONS—These data provide national reference levels for HbA_1c distributions among Americans aged 5–24 years and show statistically significant racial/ethnic differences in HbA_1c levels that are not completely explained by demographic and health-related variables.

Abbreviations: CDC, Centers for Disease Control and Prevention • HPLC, high-performance liquid chromatography • NHANES III, Third National Health and Nutrition Examination Survey • SES, socioeconomic status

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