Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes
Abstract Background Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentratio...
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doaj-5076e725afd2402c8a52256f204460ff2020-11-25T04:04:41ZengBMCCardiovascular Diabetology1475-28402019-11-011811810.1186/s12933-019-0963-5Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetesRenying Xu0Ting Zhang1Yanping Wan2Zhuping Fan3Xiang Gao4Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityVascular Surgery Department, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Digestion, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong UniversityDepartment of Nutritional Sciences, The Pennsylvania State UniversityAbstract Background Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentrations below the current cutoff for diabetes. Methods Included were 16,863 Chinese adults (aged 18 years or more; 9855 men and 7008 women) with fasting blood glucose < 7.0 mmol/L at baseline (2013). Both HbA1c level and CAP (assessed via ultrasound B-mode imaging) were annually assessed during 2014–2018. All the participants were further classified into three groups based on baseline HbA1c level: ≤ 5.6%, 5.7–6.4%, and ≥ 6.5%. We used Cox proportional-hazards model to evaluate the association between HbA1c level and incident CAP, adjusting for a series of potential confounders. Results During 5 years of follow up, 3942 incident CAP cases were identified. Individuals with higher baseline HbA1c had higher future risk of CAP (p-trend < 0.001). In the full-adjusted model, each percent increase of HbA1c was associated with a 56% (HR = 1.56, 95% CI 1.37, 1.78) higher risk of CAP. Excluding participants with chronic inflammation, as assessed by high-sensitivity C-reactive protein and white blood cell, and those with FBG ≥ 5.6 mmol/L at baseline generated similar results. Conclusions Elevated HbA1c level was associated with high risk of developing CAP in Chinese adults without FBG defined diabetes.http://link.springer.com/article/10.1186/s12933-019-0963-5Hemoglobin A1c (HbA1c)Carotid artery plaque (CAP)AdultsCohort study |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Renying Xu Ting Zhang Yanping Wan Zhuping Fan Xiang Gao |
spellingShingle |
Renying Xu Ting Zhang Yanping Wan Zhuping Fan Xiang Gao Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes Cardiovascular Diabetology Hemoglobin A1c (HbA1c) Carotid artery plaque (CAP) Adults Cohort study |
author_facet |
Renying Xu Ting Zhang Yanping Wan Zhuping Fan Xiang Gao |
author_sort |
Renying Xu |
title |
Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes |
title_short |
Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes |
title_full |
Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes |
title_fullStr |
Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes |
title_full_unstemmed |
Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes |
title_sort |
prospective study of hemoglobin a1c and incident carotid artery plaque in chinese adults without diabetes |
publisher |
BMC |
series |
Cardiovascular Diabetology |
issn |
1475-2840 |
publishDate |
2019-11-01 |
description |
Abstract Background Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentrations below the current cutoff for diabetes. Methods Included were 16,863 Chinese adults (aged 18 years or more; 9855 men and 7008 women) with fasting blood glucose < 7.0 mmol/L at baseline (2013). Both HbA1c level and CAP (assessed via ultrasound B-mode imaging) were annually assessed during 2014–2018. All the participants were further classified into three groups based on baseline HbA1c level: ≤ 5.6%, 5.7–6.4%, and ≥ 6.5%. We used Cox proportional-hazards model to evaluate the association between HbA1c level and incident CAP, adjusting for a series of potential confounders. Results During 5 years of follow up, 3942 incident CAP cases were identified. Individuals with higher baseline HbA1c had higher future risk of CAP (p-trend < 0.001). In the full-adjusted model, each percent increase of HbA1c was associated with a 56% (HR = 1.56, 95% CI 1.37, 1.78) higher risk of CAP. Excluding participants with chronic inflammation, as assessed by high-sensitivity C-reactive protein and white blood cell, and those with FBG ≥ 5.6 mmol/L at baseline generated similar results. Conclusions Elevated HbA1c level was associated with high risk of developing CAP in Chinese adults without FBG defined diabetes. |
topic |
Hemoglobin A1c (HbA1c) Carotid artery plaque (CAP) Adults Cohort study |
url |
http://link.springer.com/article/10.1186/s12933-019-0963-5 |
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