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No racial differences in the association of glycated hemoglobin with kidney disease and cardiovascular outcomes.

TitleNo racial differences in the association of glycated hemoglobin with kidney disease and cardiovascular outcomes.
Publication TypeJournal Article
Year of Publication2013
AuthorsSelvin E, Rawlings AM, Bergenstal RM, Coresh JJ
Secondary AuthorsBrancati FL
JournalDiabetes Care
Volume36
Issue10
Pagination2995-3001
Date Published2013 Oct
ISSN1935-5548
KeywordsAfrican Continental Ancestry Group, Coronary Disease, European Continental Ancestry Group, Female, Glycated Hemoglobin A, Humans, Kidney Diseases, Male, Middle Aged, Prospective Studies, Risk Factors
Abstract

OBJECTIVE: There is debate regarding the clinical significance of well-established racial differences in HbA1c. We compared the associations of diabetes diagnostic categories for HbA1c and fasting glucose with clinical outcomes in black and white persons in the community.

RESEARCH DESIGN AND METHODS: We conducted a prospective cohort analysis of participants without diabetes or cardiovascular disease from the Atherosclerosis Risk in Communities study. We examined the associations of clinical categories of HbA1c (

RESULTS: Baseline characteristics differed significantly in blacks compared with whites, including HbA1c (5.8 vs. 5.4%; P0.05) except for all-cause mortality. Patterns of association were similar, but weaker, for fasting glucose. HbA1c and fasting glucose both were more strongly associated with all-cause mortality in whites compared with blacks, largely explained by racial differences in the rate of cardiovascular deaths.

CONCLUSIONS: HbA1c is a risk factor for vascular outcomes and mortality in both black and white adults. Patterns of association for HbA1c were similar to or stronger than those for fasting glucose. With respect to long-term outcomes, our findings support a similar interpretation of HbA1c in blacks and whites for diagnosis and treatment of diabetes mellitus.

DOI10.2337/dc12-2715
Alternate JournalDiabetes Care
PubMed ID23723353
PubMed Central IDPMC3781554
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
P30 DK079637 / DK / NIDDK NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
K01 DK076595 / DK / NIDDK NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
P60 DK079637 / DK / NIDDK NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
K24 DK62222 / DK / NIDDK NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
R21 DK080294 / DK / NIDDK NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States
K24 DK062222 / DK / NIDDK NIH HHS / United States