The Use of Traditional Risk Factors to Identify Children at Risk of Prediabetes May Miss Children in Some Ethnic Groups (P11-122-19)

Abstract

Abstract Objectives To explore indicators of T2DM risk in a multi-ethnic group of children, using HbA1c as the dependent variable. Methods This data was from a subset of the 730 children recruited for the Children's Bone Study, a cross-sectional study of 8–11 year-old children in Auckland, New Zealand. Glycated haemoglobin (HbA1c) was measured from a finger-prick blood test (Roche Cobas). Anthropometry included weight, height, waist-to-height ratio (WtHR) and percentage body fat (%BF). Ethnicity, gender, age, and physical activity (PA) were assessed by questionnaires completed by the parents or guardians. Regression analysis was used to explore which independent variables best predicted variance in HbA1c. Results When children (n = 451, 10.4 + 0.6 years, 45% male) were classified by glycaemic status, 71 (15.7%) had HbA1c levels indicative of prediabetes (> 39mmol/mol), with Pacific (n = 29, 27.4%) and South Asian (n = 13, 29.5%) children, more likely to be prediabetic compared to European children (n = 10, 6.3%) (P < 0.001). WtHR and %BF together with South Asian and Pacific Island ethnicity were the most significant risk factors for elevated HbA1c and prediabetes. However, a normal %BF was still observed in 35% of children with HbA1c > 39mmol/mol, although the majority of Pacific children were in the at risk group. Conclusions South Asian and Pacific Island adults are at high risk of T2DM compared with the total New Zealand population. The prevalence of elevated HbA1c in children of these ethnicities suggests that the risk is present early in life, supporting the need for early identification and interventions in childhood to halt the progression to T2DM. Funding Sources Massey University Research Fund.