Glycated hemoglobin levels are mostly dependent on nonglycemic parameters in 9398 Finnish men without diabetes

J Clin Endocrinol Metab. 2015 May;100(5):1989-96. doi: 10.1210/jc.2014-4121. Epub 2015 Mar 3.


Context: Determinants of the variance in glycated hemoglobin (HbA1c) among individuals without type 2 diabetes remain largely unknown.

Objective: We investigated the determinants of HbA1c, fasting plasma glucose, and 2-hour glucose in an oral glucose tolerance test and the associations of these glycemic markers with insulin sensitivity and insulin secretion in Finnish men without type 2 diabetes.

Design and setting: The design and setting were the cross-sectional population-based Metabolic Syndrome in Men study including 10 197 Finnish men, aged 45-70 years, and randomly selected from the population register of Kuopio, Eastern Finland.

Participants: Participants were a total of 9398 men without type 2 diabetes or with newly diagnosed type 2 diabetes at baseline (mean age 57 ± 7 y; body mass index 27.0 ± 4.0 kg/m(2), mean ± SD) in the Metabolic Syndrome in Men study cohort.

Interventions: The intervention included an oral glucose tolerance test.

Main outcome measures: Glycemic and nonglycemic determinants of the variance in HbA1c among participants without type 2 diabetes and the association of HbA1c with insulin secretion and insulin sensitivity were measured.

Results: Age, fasting plasma glucose, and high-sensitivity C-reactive protein were the strongest determinants of HbA1c, explaining 12% of the variance in HbA1c levels in participants without type 2 diabetes. Disposition index (insulin secretion) and the Matsuda insulin sensitivity index (insulin sensitivity) explained only less than 2% of the variance in HbA1c in the participants without type 2 diabetes.

Conclusions: The variance in HbA1c among men without type 2 diabetes was largely determined by nonglycemic factors and only weakly by impaired insulin sensitivity and insulin secretion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Blood Glucose / analysis*
  • Body Mass Index
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Finland
  • Glucose Tolerance Test
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Insulin / blood
  • Insulin Resistance
  • Male
  • Middle Aged


  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin