Send to

Choose Destination
Int J Obes (Lond). 2014 Sep;38 Suppl 2:S39-47. doi: 10.1038/ijo.2014.134.

Percentiles of fasting serum insulin, glucose, HbA1c and HOMA-IR in pre-pubertal normal weight European children from the IDEFICS cohort.

Author information

Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain.
Research & Education Institute of Child Health, Strovolos, Cyprus.
Medizinisches Versorgungszentrum (MVZ), Dr Eberhard und Partner Dortmund, Dortmund, Germany.
Epidemiology and Population Genetics, Institute of Food Science, CNR, Avellino, Italy.
Centre for High Technology Research and Education in Biomedical Sciences, Universita Cattolica del Sacro Cuore, Campobasso, Italy.
National Institute for Health Development (NIHD), Tallinn, Estonia.
Department of Public Health, Ghent University, Ghent, Belgium.
Department of Paedriatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
Chronic Diseases Department, National Institute of Health Promotion, University of Pécs, Pécs, Hungary.
1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Institute of Statistics, Faculty of Mathematics and Computer Science, University Bremen, Bremen, Germany.



The aim of this study is to present age- and sex-specific reference values of insulin, glucose, glycosylated haemoglobin (HbA1c) and the homeostasis model assessment to quantify insulin resistance (HOMA-IR) for pre-pubertal children.


The reference population consists of 7074 normal weight 3- to 10.9-year-old pre-pubertal children from eight European countries who participated in at least one wave of the IDEFICS ('identification and prevention of dietary- and lifestyle-induced health effects in children and infants') surveys (2007-2010) and for whom standardised laboratory measurements were obtained. Percentile curves of insulin (measured by an electrochemiluminescence immunoassay), glucose, HbA1c and HOMA-IR were calculated as a function of age stratified by sex using the general additive model for location scale and shape (GAMLSS) method.


Levels of insulin, fasting glucose and HOMA-IR continuously show an increasing trend with age, whereas HbA1c shows an upward trend only beyond the age of 8 years. Insulin and HOMA-IR values are higher in girls of all age groups, whereas glucose values are slightly higher in boys. Median serum levels of insulin range from 17.4 and 13.2 pmol l(-1) in 3-<3.5-year-old girls and boys, respectively, to 53.5 and 43.0 pmol l(-1) in 10.5-<11-year-old girls and boys. Median values of glucose are 4.3 and 4.5 mmol l(-1) in the youngest age group and 49.3 and 50.6 mmol l(-1) in the oldest girls and boys. For HOMA-IR, median values range from 0.5 and 0.4 in 3-<3.5-year-old girls and boys to 1.7 and 1.4 in 10.5-<11-year-old girls and boys, respectively.


Our study provides the first standardised reference values for an international European children's population and provides the, up to now, largest data set of healthy pre-pubertal children to model reference percentiles for markers of insulin resistance. Our cohort shows higher values of Hb1Ac as compared with a single Swedish study while our percentiles for the other glucose metabolic markers are in good accordance with previous studies.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Nature Publishing Group
Loading ...
Support Center