133-LB: Relationship of HbA1c and Glucose by Ethnicity in UK Biobank

The UK Biobank recruited 502,481 people aged 40 to 70 years who were invited to participate by post so not necessarily representative of the general population. The 405,363 participants with random glucose, HbA_1c and the necessary demographic/clinical data were aged 56.5 (8.09) years, mean SD, with 54% female, and ethnicity 95.0% White W, 1.9 South Asian SA, 1.3% Black B, 0.9% Other O, 0.6% Mixed Background MB, and 0.3% Chinese C. Glucose was measured by hexokinase and HbA_1c by BioRad VARIANT II TURBO analysers, reference range 20-42 mmol/mol in a dedicated central laboratory. Cohen's D statistic was used to compare glucose/HbA_1c by ethnicity versus the largest group W. Mean glucose ranged from 5.04 to 5.41 mmol/L with HbA_1c40.7 mmol/mol for SAversus36.0 for W (D=0.78 medium effect M) , B 39.3 (D=0.51 M) , O 38.4 (D=0.37 small S) , C 37.1 (D=0.17 very small V) & MB 36.6 (D=0.09 V) , all p values <0.001. There were large differences by ethnicity in linear regression slopes for the glucose/HbA_1c relationship when compared to W with correlation coefficient comparison Z-statistics for SA 16.74, B 8.69, O 10.94, C 8.96, all p<0.001, except for MB 2.56, p=0.01. Such ethnic differences in HbA_1c have been reported previously and questions raised as whether different cut-offs should be used for diagnosis of diabetes. However, more information on the prevalence of microvascular complications and differences in haematological profiles is required for such modifications.

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