Glycated hemoglobin predicts overall and cardiovascular mortality in non-diabetic hemodialysis patients

Ok, Ebru Sevinç; Aşçı, Gülay; Töz, Hüseyin; Ritz, Eberhard; Kırçelli, Fatih; Sever, Mehmet Şükrü; Özkahya, Mehmet; Sipahi, Savaş; Dheir, Hamad; Bozkurt, Devrim; Ömer, Ziya; Şahin, Osman; Ertilav, Muhittin; Ok, Ercan

doi:10.5414/cn108251

Cited by 7 publications

(4 citation statements)

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“… 27 , 28 , 29 Furthermore, higher HbA1c is associated with greater risk of mortality among nondiabetic patients with non−dialysis-dependent chronic kidney disease, 30 as well as among nondiabetic patients on hemodialysis. 31 Therefore, HbA1c could also be a useful tool for pretransplantation PTDM risk evaluation, based on our findings.…”

Section: Discussionsupporting

confidence: 56%

Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

Palta

Djamali

Astor

2017

Kidney International Reports

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IntroductionPosttransplantation diabetes mellitus (PTDM) is a common complication among kidney transplant recipients and is associated with a higher risk of cardiovascular events and poorer graft and patient survival. The association of pretransplantation hemoglobin A1c (HbA1c) with PTDM remains unclear. Identifying recipients at greatest risk for PTDM may help guide monitoring and treatment strategies to prevent or delay the onset of PTDM.MethodsWe analyzed data from 1499 nondiabetic primary kidney transplant recipients with available pretransplantation HbA1c values in the United States Renal Data System (USRDS) from 2005 to 2011. Recipients with pretransplantation diabetes diagnosis or HbA1c ≥ 6.5% were excluded. We assessed the association of pretransplantation HbA1c with PTDM using Cox proportional hazards models. Pretransplantation HbA1c level as a continuous variable was modeled using restricted cubic splines with knots at the 25th, 50th, and 75th percentiles. Based on results from this model, pretransplantation HbA1c was further modeled using a linear spline with a single knot at 5.4%.ResultsA total of 395 recipients (26.4%) developed PTDM over a median follow-up of 1.8 years. Pretransplantation HbA1c was not significantly associated with risk of PTDM below 5.4%, whereas each 1% higher HbA1c above 5.4% was associated with an adjusted hazard ratio of 1.84 (95% confidence interval = 1.28, 2.66; P for change in slope = 0.04).DiscussionHigher pretransplantation HbA1c above 5.4% is independently associated with greater risk of PTDM among kidney transplant recipients. A continuous relationship between pretransplantation HbA1c and risk of PTDM suggests that increased risk starts at HbA1c levels well below current thresholds for prediabetes.

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Section: Discussionsupporting

confidence: 56%

Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

Palta

Djamali

Astor

2017

Kidney International Reports

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“…Несмотря на определенную недостоверность значений HbA 1c в оценке гликемического статуса у диализных пациентов, данный показатель может использоваться для оценки риска смертности у больных с ХБП [30]. S. Ok и соавт.…”

Section: особенности метаболизма глюкозы и интерпретации значений био...unclassified

“…в рандомизированном контролируемом исследовании с участием 489 гемодиализных пациентов без СД выявили с помощью регрессионного анализа Кокса, что значение HbA 1c >5,04% независимо ассоциировано как с общей (ОР=3,60, 95% ДИ 1,57-8,27, p=0,002), так и с сердечно-сосудистой (ОР=6,66, 95% ДИ 1,51-29,4; p=0,01) смертностями. С помощью метода Каплана-Мейера установили, что худший прогноз выживаемости имели пациенты с самым низким (<4,69%) и с самым высоким показателями HbA 1c (>5,04%), период наблюдения составил 3 года [30]. P.P.…”

Section: особенности метаболизма глюкозы и интерпретации значений био...unclassified

Prevalence of carbohydrate metabolism disorders in patients with end-stage renal disease on hemodialysis therapy

Markova

Yavorskaya

2022

Diabetes mellitus

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There are quite a lot of scientific works today dedicated to the role of disorders carbohydrate metabolism (DCM) in the development of end-stage renal disease (ESRD), at the same time, the influence of chronic kidney disease (CKD) on the development of carbohydrate disorders remains insufficiently studied, especially in patients on renal replacement therapy (RRT). The annual steady increase in the number of patients with ESRD without diabetes mellitus (DM) requiring dialysis therapy leads to increased interest and the need to study carbohydrate status in these patients. It is known that hyperglycemia in patients without DM on hemodialysis (HD) is a predisposing factor to the development of cardiovascular accidents that worsen the quality of life and also increase mortality. The peculiarities of glucose metabolism in patients receiving RRT do not always allow adequate assessment of carbohydrate status using glycated hemoglobin (HbA1c). The review provides up-to-date information on the prevalence of DCM in patients with ESRD without DM receiving HD RRT, touches upon the peculiarities of glucose metabolism, interpretation of HbA1c and glycated albumin values, and mortality risk in hemodialysis patients with various DCM.

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“…However, no correlation was found between admission glucose or fasting glucose levels and severity of coronary artery disease [ 8 ]. In addition, an upper-normal HbA 1c level was associated with cardiovascular and overall mortality in non-diabetic hemodialysis patients, whereas a lower HbA 1c level was not [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Longitudinal Change of Glycated Hemoglobin in a Large Non-Diabetic Population

Lee

Chen

et al. 2021

JPM

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Although many cross-section studies have assessed the determinants of glycated hemoglobin (HbA1c), there have been limited studies designed to evaluate the temporal correlates of HbA1c in non-diabetic patients. This study aimed to identify the major determinants of longitudinal change of HbA1c in non-diabetic patients. This study included subjects from the 104,451 participants enrolled between 2012 and 2018 in the Taiwan Biobank. We only included participants with complete data at baseline and follow-up (n = 27,209). Patients with diabetes at baseline or follow-up (n = 3983) were excluded. Finally, 23,226 participants without diabetes at baseline and follow-up were selected in this study. △Parameters was defined as the difference between the measurement baseline and follow-up. Multivariable linear regression analysis was used to identify the major determinants of HbA1c longitudinal change (△HbA1c). During a mean 3.8 year follow-up, after multivariable analysis, new-onset hypertension (coefficient β: 0.014, p < 0.001), high △heart rate (coefficient β: 0.020, p = 0.002), high △BMI (coefficient β: 0.171, p = 0.028), high △fasting glucose (coefficient β: 0.107, p < 0.001), low △creatinine (coefficient β: −0.042, p < 0.001), high △total cholesterol (coefficient β: 0.040, p < 0.001), high △hemoglobin (coefficient β: 0.062, p < 0.001), high △GPT (coefficient β: 0.041, p = 0.001), and low △albumin (coefficient β: −0.070, p < 0.001) were significantly associated with high △HbA1c. In non-diabetic population, strategies to decrease the development of new-onset hypertension, resting heart rate, body mass index, fasting glucose, total cholesterol, and GPT and increase serum albumin level might be helpful in slowing the longitudinal change of HbA1c. In addition, increased hemoglobin and decreased serum creatinine over time also had an impact on the HbA1c elevation over time in non-diabetic population.

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Glycated hemoglobin predicts overall and cardiovascular mortality in non-diabetic hemodialysis patients

Cited by 7 publications

References 0 publications

Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

Higher Pretransplantation Hemoglobin A1c Is Associated With Greater Risk of Posttransplant Diabetes Mellitus

Prevalence of carbohydrate metabolism disorders in patients with end-stage renal disease on hemodialysis therapy

Determinants of Longitudinal Change of Glycated Hemoglobin in a Large Non-Diabetic Population

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