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Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study.

TitleGlycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study.
Publication TypeJournal Article
Year of Publication2005
AuthorsSelvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW
JournalArch Intern Med
Volume165
Issue16
Pagination1910-6
Date Published2005 Sep 12
ISSN0003-9926
KeywordsBlood Glucose, Case-Control Studies, Coronary Artery Disease, Diabetes Complications, Diabetes Mellitus, Female, Follow-Up Studies, Glycated Hemoglobin A, Humans, Male, Middle Aged, Prospective Studies, Risk Factors
Abstract

BACKGROUND: Chronic hyperglycemia has been hypothesized to contribute to coronary heart disease (CHD), but the extent to which hemoglobin A(1c) (HbA(1c)) level, a marker of long-term glycemic control, is independently related to CHD risk is uncertain.

METHODS: We conducted a prospective case-cohort study of 1321 adults without diabetes and a cohort study of 1626 adults with diabetes from the Atherosclerosis Risk in Communities Study. Using proportional hazards models, we assessed the relation between HbA(1c) level and incident CHD during 8 to 10 years of follow-up.

RESULTS: In adults with diabetes, the relative risk (RR) of CHD was 2.37 (95% confidence interval [CI], 1.50-3.72) for the highest quintile of HbA(1c) level compared with the lowest after adjustment for CHD risk factors. In persons without diabetes, the adjusted RR of CHD in the highest quintile of HbA(1c) level was 1.41 (95% CI, 0.90-2.30); however, there was evidence of a nonlinear relationship in this group. In nondiabetic adults, HbA(1c) level was not related to CHD risk below a level of 4.6% but was significantly related to risk above that level (P<.001 in="" diabetic="" adults="" the="" risk="" of="" chd="" increased="" throughout="" range="" hba="" levels.="" adjusted="" model="" rr="" for="" a="" point="" increase="" level="" was="" ci="" persons="" without="" diabetes="" but="" with="" an="" greater="" than="" per="" across="" full="" values.="">

CONCLUSION: Elevated HbA(1c) level is an independent risk factor for CHD in persons with and without diabetes.

DOI10.1001/archinte.165.16.1910
Alternate JournalArch Intern Med
PubMed ID16157837
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
N01-HC-55019 / HC / NHLBI NIH HHS / United States
N01-HC-55020 / HC / NHLBI NIH HHS / United States
N01-HC-55021 / HC / NHLBI NIH HHS / United States
N01-HC-55022 / HC / NHLBI NIH HHS / United States
T32HL07024 / HL / NHLBI NIH HHS / United States