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Glycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study.

TitleGlycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2005
AuthorsSelvin E, Coresh J, Shahar E, Zhang L, Steffes M, A Sharrett R
JournalLancet Neurol
Volume4
Issue12
Pagination821-6
Date Published2005 Dec
ISSN1474-4422
KeywordsAtherosclerosis, Blood Glucose, Body Mass Index, Community Health Services, Diabetes Complications, Diabetes Mellitus, Glycated Hemoglobin A, Humans, Hyperglycemia, Incidence, Longitudinal Studies, Male, Retrospective Studies, Risk, Stroke
Abstract

BACKGROUND: Individuals with diabetes have a raised risk of stroke, but it is unclear whether sustained hyperglycaemia contributes to the development of cerebrovascular disease. Haemoglobin A1c (HbA(1c)), a measure of long-term glycaemia, is strongly related to retinopathy, nephropathy, and neuropathy in diabetes. We sought to assess the association between HbA(1c) and stroke in people with and without diabetes.

METHODS: 10,886 participants without diabetes and 1635 participants with diabetes in the ARIC study, who did not have cardiovascular disease, were followed up for incident ischaemic stroke over 8-10 years. We assayed HbA(1c) for all 167 stroke cases and a sample of 680 non-cases in the adults without diabetes and for the full cohort of 1635 adults with diabetes (including 89 stroke cases). We assessed the relation between HbA(1c) concentrations (in tertiles specific for individuals with and without diabetes) and incident ischaemic stroke during follow-up using Cox proportional hazards models, controlling for risk factors for stroke.

FINDINGS: The adjusted relative risks of stroke increased with increasing tertile of HbA1c in both adults without diabetes (p=0.02) and with diabetes (p

INTERPRETATION: Raised HbA(1c) could be an independent risk factor for stroke in people with and without diabetes, with relative risks similar to those previously reported for coronary heart disease.

DOI10.1016/S1474-4422(05)70227-1
Alternate JournalLancet Neurol
PubMed ID16297840
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