title: Factors Affecting Hemoglobin A1C in the Diagnosis of Diabetes and Prediabetes in Youth.
abstract: We sought to examine the correlation between variables and A1C levels to determine if prediction modeling could be used in the screening and diagnosis of diabetes and prediabetes in youth. We also sought to test relationships between A1C levels to insulin sensitivity indices and β-cell function indices.
  
  
  METHODS
  We performed a retrospective review of 904 medical records from youth deemed at-risk for the disease. We performed Pearson correlation, multiple regression, and simple regression testing to determine the relationship between variables and A1C levels. In addition, we performed Pearson correlation testing on insulin sensitivity indices and β-cell function indices to determine the strength of correlation to A1C levels.
  
  
  RESULTS
  Statistical analysis did not show a strong relationship between the variables tested and the A1C. When racial and ethnic groups were tested together, the results from African American participants resulted in bias estimates, and as a result, a statistical model for the entire sample could not be performed. Results indicate that A1C is correlated with all β-cell function proxy measurements and correlated to the corrected insulin level at 30minutes, but not the fasting insulin or insulinogenic index.
  
  
  CONCLUSIONS
  The results from this study underline the multi-dimensional causes of diabetes and prediabetes and further stress the difficulties in predicting the diseases. The causes of diabetes and prediabetes are multifaceted, often individualized, and often difficult to ascertain.
  
  
  CONCLUSIONS
  Clinicians should continue to examine a variety of variables prior to determining the need for diabetes diagnostic testing.
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN. Electronic address: jhitt@uthsc.edu.
authors.forename: Jennifer McGuire
authors.initials: JM
authors.lastname: Hitt
authors.affiliation: LifeDoc Diabetes and Obesity Clinic, Memphis, TN.
authors.forename: Pedro
authors.initials: P
authors.lastname: Velasquez-Mieyer
authors.affiliation: LifeDoc Diabetes and Obesity Clinic, Memphis, TN.
authors.forename: Claudia
authors.initials: C
authors.lastname: Neira
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Patricia
authors.initials: P
authors.lastname: Cowan
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Adolescents; Children; Diabetes; Prediabetes; Screening