Differences in Hemoglobin A1c Between Hispanics/Latinos and Non-Hispanic Whites: An Analysis of the Hispanic Community Health Study/Study of Latinos and the 2007-2012 National Health and Nutrition Examination Survey

Diabetes Care. 2016 Jun;39(6):1010-7. doi: 10.2337/dc15-2579. Epub 2016 Apr 18.


Objective: To determine whether, after adjustment for glycemia and other selected covariates, hemoglobin A1c (HbA1c) differed among adults from six Hispanic/Latino heritage groups (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) and between Hispanic/Latino and non-Hispanic white adults without self-reported diabetes.

Research design and methods: We performed a cross-sectional analysis of data from 13,083 individuals without self-reported diabetes from six Hispanic/Latino heritage groups, enrolled from 2008 to 2011 in the Hispanic Community Health Study/Study of Latinos, and 2,242 non-Hispanic white adults enrolled during the 2007-2012 cycles of the National Health and Nutrition Examination Survey. We compared HbA1c levels among Hispanics/Latinos and between Hispanics/Latinos and non-Hispanic whites before and after adjustment for age, sex, fasting (FPG) and 2-h post-oral glucose tolerance test (2hPG) glucose, anthropometric measurements, and selected biochemical and hematologic variables and after stratification by diabetes status: unrecognized diabetes (FPG ≥7.1 mmol/L or 2hPG ≥11.2 mmol/L), prediabetes (FPG 5.6-7.0 mmol/L or 2hPG 7.8-11.1 mmol/L), and normal glucose tolerance (FPG <5.6 mmol/L and 2hPG <7.8 mmol/L).

Results: Adjusted mean HbA1c differed significantly across all seven groups (P < 0.001). Non-Hispanic whites had significantly lower HbA1c (P < 0.05) than each individual Hispanic/Latino heritage group. Upon stratification by diabetes status, statistically significant differences (P < 0.001) in adjusted mean HbA1c persisted across all seven groups.

Conclusions: HbA1c differs among Hispanics/Latinos of diverse heritage groups and between non-Hispanic whites and Hispanics/Latinos after adjustment for glycemia and other covariates. The clinical significance of these differences is unknown.

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Central America
  • Cross-Sectional Studies
  • Cuba
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / metabolism*
  • Fasting
  • Female
  • Glucose Tolerance Test
  • Glycated Hemoglobin / metabolism*
  • Hispanic or Latino*
  • Humans
  • Male
  • Mexican Americans
  • Mexico
  • Middle Aged
  • Nutrition Surveys
  • Prediabetic State / diagnosis
  • Prediabetic State / metabolism*
  • Puerto Rico
  • South America
  • White People*


  • Blood Glucose
  • Glycated Hemoglobin A