Since little is known on the distribution and cardiovascular correlates of glycated hemoglobin (HbA1c) in young nondiabetic individuals, the Bogalusa Heart Study examined this question as a function of sex and ethnicity. The study showed that black individuals had higher HbA1c levels than white individuals and that women had greater HbA1c levels than men. There were relationships between body mass index, waist circumference, LDL cholesterol, HDL cholesterol, cholesterol/HDL cholesterol ratio, insulin, glucose, the homeostasis model assessment of insulin resistance, and HbA1c levels. Furthermore, in a multivariate analysis, sex, race, cholesterol/HDL cholesterol ratio, and waist circumference were independent correlates of HbA1c. Finally, the prevalence of elevated HbA1c concentrations was 1.6-fold (p<0.05) higher in individuals with the metabolic syndrome (NCEP-ATP III), 2.1-fold (p<0.01) higher in those with positive parental history of cardiovascular disease, and 1.5-fold higher (p<0.05) in those with parental history of type 2 diabetes. Therefore, these results suggest that HbA1c, even in the reference range, could be of potential value in the assessment of cardiovascular disease and type 2 diabetes risk in apparently healthy individuals.
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