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Glycosylated hemoglobin level and carotid intimal-medial thickening in nondiabetic individuals. The Atherosclerosis Risk in Communities Study.

TitleGlycosylated hemoglobin level and carotid intimal-medial thickening in nondiabetic individuals. The Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication1997
AuthorsVitelli LL, Shahar E, Heiss G, McGovern PG, Brancati FL, Eckfeldt JH, Folsom AR
JournalDiabetes Care
Volume20
Issue9
Pagination1454-8
Date Published1997 Sep
ISSN0149-5992
KeywordsArteriosclerosis, Carotid Artery Diseases, Case-Control Studies, Cohort Studies, Female, Follow-Up Studies, Glycated Hemoglobin A, Humans, Logistic Models, Male, Middle Aged, Risk Factors, Ultrasonography
Abstract

OBJECTIVE: People with diabetes are at increased risk for cardiovascular events. However, questions remain about what role, if any, homeostatic glucose control plays in the development of cardiovascular disease among nondiabetic individuals. We investigated the relationship between HbA1c level and carotid intimal-medial thickening in normoglycemic individuals.

RESEARCH DESIGN AND METHODS: We conducted a case-control study among 208 normoglycemic individuals (fasting glucose

RESULTS: HbA1c levels, expressed as percent of total hemoglobin, ranged from 4 to 7% and correlated only modestly with single measurements of fasting glucose (r = 0.16) and fasting insulin (r = 0.14). The mean level of HbA1c was 5.18% among case subjects and 5.07% among control subjects (P = 0.004, paired t test). As compared with the first quartile of HbA1c the matched relative odds of being a case were 1.15, 1.33, and 2.30 for the second, third, and fourth quartiles, respectively (P = 0.005 for linear trend). After multivariate adjustment for age, fasting glucose, fasting insulin, BMI, smoking status, hypertension, LDL cholesterol, HDL cholesterol, fibrinogen, and education level, the respective relative odds estimates were 0.98, 1.07, and 1.88 (P = 0.16 for linear trend). When modeled linearly as a continuous variable and after adjustment for the above-mentioned covariates, a 1% point increment in HbA1c level was associated with 1.77 greater odds of being a case (95% CI, 0.9-3.5).

CONCLUSIONS: These data provide some support to the hypothesis that in the absence of diabetes, homeostatic glycemic control is a risk factor for atherosclerosis.

DOI10.2337/diacare.20.9.1454
Alternate JournalDiabetes Care
PubMed ID9283796
Grant ListN01-HC-55015 / HC / NHLBI NIH HHS / United States
N01-HC-55016 / HC / NHLBI NIH HHS / United States
N01-HC-55018 / HC / NHLBI NIH HHS / United States