Ren Longbing, Yang Jing, Wu Lezhou, Gao Yan, Zhou Zhitong, Li Pin, Shen Zhiping, Wu Juanli, Li Jue, Zhang Lijuan
Clinical Center for Intelligent Rehabilitation Research Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center) Tongji University School of Medicine Tongji University, Shanghai 201613, China.
Community Health Service Center of Anting Town Affiliated with Medical College of Tongji University, Shanghai 201805, China.
Pediatr Diabetes. 2024 Jul 29;2024:8333590. doi: 10.1155/2024/8333590. eCollection 2024.
Capillary glycated hemoglobin (HbA1c) may enhance screening for childhood prediabetes and diabetes, but variations in this parameter remain unclear. We aimed to develop percentiles of HbA1c and explore the influence of various variables on HbA1c level among Chinese children. . The data were derived from the Shanghai Children's Health and Nutrition Community-based Epidemiologic Survey (CHANCE). A total of 4,615 children aged 3-12 years were included. The capillary HbA1c level was measured using point-of-care (POC) testing analyzers. Abnormal HbA1c level was identified as HbA1c (%) value equal to or above the 95th percentile of the nomograms.
The mean HbA1c value was 5.30% (SD = 0.50%). The age-specific 95th percentile thresholds of HbA1c (%) ranged from 5.9 to 6.2 among all children. In the whole participants, body mass index (BMI), total cholesterol (TC), outdoor activity frequency, and daily sleep duration were positively associated with high HbA1c. Among preschool-aged children, TC and sleep duration ≥10 hr per day were associated with increased risk of being in the higher HbA1c (both < 0.05). Among the school-aged group, positive associations with HbA1c levels were identified for TC, living with grandparents, frequency of outdoor activity, and sleep duration (all < 0.05).
The present study established capillary HbA1c percentiles based on a large sample of Chinese children among aged 3-12 years. Daily sleep duration and frequency of outdoor activity, BMI, and TC were found to be associated with high HbA1c. Actions of successful public strategies that focus on promoting a healthy lifestyle, including regular physical exercise to reduce weight among children, are needed. . We used POC testing for capillary HbA1c with a finger-stick sample which may offer an opportunity to enhance screening and early diagnosis for childhood and adolescent diabetes, which was suggested as an essential premise to determine the subject's glycemic status by the American Diabetes Association (ADA). Capillary HbA1c levels fluctuate during childhood, while there has been no population-based study on HbA1c reference values in Chinese youths.
毛细血管糖化血红蛋白（HbA1c）可能有助于儿童糖尿病前期和糖尿病的筛查，但该参数的变化尚不清楚。我们旨在制定HbA1c百分位数，并探讨各种变量对中国儿童HbA1c水平的影响。数据来源于上海儿童健康与营养社区流行病学调查（CHANCE）。共纳入4615名3至12岁的儿童。使用即时检测（POC）分析仪测量毛细血管HbA1c水平。异常HbA1c水平定义为HbA1c（%）值等于或高于列线图的第95百分位数。
HbA1c平均值为5.30%（标准差=0.50%）。所有儿童中，按年龄划分的HbA1c（%）第95百分位数阈值在5.9至6.2之间。在所有参与者中，体重指数（BMI）、总胆固醇（TC）、户外活动频率和每日睡眠时间与高HbA1c呈正相关。在学龄前儿童中，TC和每天睡眠时间≥10小时与HbA1c处于较高水平的风险增加相关（均P<0.05）。在学龄儿童组中，发现TC、与祖父母同住、户外活动频率和睡眠时间与HbA1c水平呈正相关（均P<0.05）。
本研究基于大量3至12岁中国儿童建立了毛细血管HbA1c百分位数。发现每日睡眠时间、户外活动频率、BMI和TC与高HbA1c相关。需要采取成功的公共策略行动，重点是促进健康的生活方式，包括定期体育锻炼以减轻儿童体重。我们使用POC检测法通过手指采血样本检测毛细血管HbA1c，这可能为加强儿童和青少年糖尿病的筛查和早期诊断提供机会，美国糖尿病协会（ADA）建议这是确定受试者血糖状态的重要前提。儿童期毛细血管HbA1c水平会波动，而中国青少年中尚未有基于人群的HbA1c参考值研究。
