Independent Association of HbA1c and Incident Cardiovascular Disease in People Without Diabetes
- 1 March 2009
- Vol. 17 (3), 559-563
- https://doi.org/10.1038/oby.2008.592
Abstract
Recent studies have reported no association between elevated glycated hemoglobin (HbA(1c)) and incident cardiovascular disease (CVD) among women without diabetes. This study describes associations between HbA(1c) and new onset CVD in a representative adult population cohort. Assessment of participants in The North West Adelaide Health Study (NWAHS), a population study of randomly selected adults (age > or =18 years, n = 4,060), included measurement of height, weight, blood pressure, fasting lipids, glucose, and HbA(1c). A self-completed questionnaire assessed doctor-diagnosed diabetes, CVD and stroke, smoking status, and demographics. The cohort was followed for an average 3.5 years. Of the 2,913 adults free of diabetes at baseline and follow-up, 94 (3.5%) reported new onset coronary heart disease (CHD) and/or stroke. Compared with those with an HbA(1c) < or =5.0%, risk of new onset CVD was increased in those with HbA(1c) 5.4-5.6% (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4, 4.6), and > or =5.7% (OR 1.9, 95% CI 1.1, 3.4), after adjustment for other risk factors. The association was stronger in women than men (P = 0.03), and attenuated to only a small degree by addition of impaired fasting glucose (IFG), hypertension, hypercholesterolemia, BMI, waist circumference, or smoking to the model. Elevated HbA(1c) is related to new onset CVD over a relatively short follow-up period in both men and women without diabetes and who do not develop diabetes, after adjustment for other major risk factors. Unlike previous studies, this relationship was not substantially attenuated by other traditional risk factors.This publication has 31 references indexed in Scilit:
- Independent Associations of Fasting Insulin, Glucose, and Glycated Haemoglobin with Stroke and Coronary Heart Disease in Older WomenPLoS Medicine, 2007
- Glycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis Risk in Communities (ARIC) StudyThe Lancet Neurology, 2005
- Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studiesBMJ, 2005
- Glycemic Control and Coronary Heart Disease Risk in Persons With and Without DiabetesArchives of Internal Medicine, 2005
- Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With DiabetesDiabetes Care, 2005
- Association of Hemoglobin A1c with Cardiovascular Disease and Mortality in Adults: The European Prospective Investigation into Cancer in NorfolkAnnals of Internal Medicine, 2004
- Glucose Metabolism and Coronary Heart Disease in Patients With Normal Glucose ToleranceJAMA, 2004
- Hemoglobin A1c Level and Future Cardiovascular Events Among WomenArchives of Internal Medicine, 2004
- The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years.Diabetes Care, 1999
- GHb Is a Better Predictor of Cardiovascular Disease Than Fasting or Postchallenge Plasma Glucose in Women Without Diabetes: The Rancho Bernardo StudyDiabetes Care, 1996