Fasting plasma glucose and HbA1c in cardiovascular risk prediction: a sex-specific comparison in individuals without diabetes mellitus

Schöttker, Ben; Müller, Heiko; Rothenbacher, Dietrich; Brenner, Hermann

doi:10.1007/s00125-012-2707-x

Cited by 37 publications

(34 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the finding of no association between prediabetes and all-cause mortality in the current study, prediabetes might still be relevant for other clinical outcomes. HbA 1c levels in the prediabetic range have been shown to be associated with an increased risk for coronary heart disease and stroke in some but not all studies (6,7,31).…”

Section: Discussionmentioning

confidence: 99%

Association Between Hemoglobin A1c and All-Cause Mortality: Results of the Mortality Follow-up of the German National Health Interview and Examination Survey 1998

et al. 2014

View full text Add to dashboard Cite

OBJECTIVEThis study examined the association of HbA 1c -defined glycemic status and continuous HbA 1c with all-cause mortality. RESEARCH DESIGN AND METHODSThe study population comprised 6,299 participants (aged 18-79 years) of the German National Health Interview and Examination Survey 1998, who were followed up for mortality for an average of 11.6 years. Glycemic status was defined as known diabetes (self-reported diagnosis or intake of antidiabetic medication) and based on Spline models revealed a U-shaped association, with lowest risk at HbA 1c levels 5.4-5.6% (36-38 mmol/mol) and a significantly increased risk at £5.0% (£31 mmol/mol) and ‡6.4% ( ‡46 mmol/mol). CONCLUSIONSUnlike known and undiagnosed diabetes, HbA 1c levels in the prediabetic range were not associated with an increased mortality risk. The observed U-shaped relationship adds to existing evidence that not only high but also low HbA 1c levels might be associated with all-cause mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Association Between Hemoglobin A1c and All-Cause Mortality: Results of the Mortality Follow-up of the German National Health Interview and Examination Survey 1998

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Subsequent analyses of frozen samples from the Atherosclerosis Risk in Communities (ARIC) cohort extended these findings to suggest that HbA 1c improves reclassification of CHD risk (1,198 incident events) in men and women combined (no sex interaction) beyond established predictors by around 2.7% [6] although, of note, blood pressure was adjusted only as a categorical 'yes/no' variable, which is a potential limitation. A more recent analysis using a German cohort with >700 incident events could not confirm a clear reclassification benefit of adding HbA 1c to the Systematic Coronary Risk Evaluation Chart (SCORE) for individuals without diabetes mellitus [7]. Hence, this is an area in need of more detailed study as the data are inconclusive at present.…”

Section: Do Glycaemia Levels Matter To Cvd Risk In Those Without Diabmentioning

confidence: 99%

Revisiting the links between glycaemia, diabetes and cardiovascular disease

2013

View full text Add to dashboard Cite

Whilst the interplay between type 2 diabetes and cardiovascular disease (CVD) has been recognised for many years, recent analyses of existing studies have helped refine several aspects of this relationship with relevance to clinical practice. First, recent data demonstrate that fasting glucose is not linearly related to CVD risk in those without diabetes; rather, risk levels escalate (modestly at first) only beyond specific glucose thresholds. Consequently, glucose-based measures may not necessarily enhance CVD risk prediction in those without diabetes. Second, other data confirm that new-onset diabetes is not a post-myocardial infarction 'risk equivalent' state and that, on average, several years of diabetes duration is needed to attain this level of risk. Third, meta-analyses and systemic reviews have confirmed that diabetes increases CVD risk by around twofold on average and this risk is subject to wide variation, being lowest in those newly diagnosed and highest in those with existing vascular disease, proteinuria or renal disease. Fourth, metaanalyses of major glucose-lowering trials suggest that, whilst glucose-lowering lessens vascular risk, risk reduction arising from statins and blood pressure-lowering is greater. Fifth, statins increase diabetes risk, albeit modestly, adding to the emerging concept that some agents that primarily target CVD risk may be diabetogenic, and vice versa. Finally, arising in part from the latter observation, as well as an understanding that CVD and diabetes risk overlap in some individuals but not others, the case for combined CVD/ diabetes risk screening (generally using non-fasting lipids and HbA 1c ), has gained strength.

show abstract

“…Though several studies demonstrated a linear relationship between HbA1 c and several outcomes throughout the range of values [12,13], numerous recent studies showed that low HbA1 c in nondiabetic [14,15] or diabetic individuals [16,17] is associated with increased mortality. Such association suggests the involvement of HbA1 c levels in autoimmune activation and may be confined to one gender (e.g.…”

Section: Journal Of Clinical and Cellular Immunologymentioning

confidence: 99%

Underlying Autoimmune Activation Rendering Paradoxical Non-Linear Relationship between Biomarkers and Cardiometabolic Risk

Onat¹,

Kaya²

2016

J Clin Cell Immunol

View full text Add to dashboard Cite

Fasting plasma glucose and HbA1c in cardiovascular risk prediction: a sex-specific comparison in individuals without diabetes mellitus

Cited by 37 publications

References 34 publications

Association Between Hemoglobin A1c and All-Cause Mortality: Results of the Mortality Follow-up of the German National Health Interview and Examination Survey 1998

Association Between Hemoglobin A1c and All-Cause Mortality: Results of the Mortality Follow-up of the German National Health Interview and Examination Survey 1998

Revisiting the links between glycaemia, diabetes and cardiovascular disease

Underlying Autoimmune Activation Rendering Paradoxical Non-Linear Relationship between Biomarkers and Cardiometabolic Risk

Contact Info

Product

Resources

About