Haemoglobin A1c is associated with carotid intima-media thickness in a Chinese population

Hung, Chi Sheng; Lee, Po‐Chu; Li, Chung‐Yi; Ma, Wen-Ya; Lin, Ming‐Chung; Wei, Jung-Nan; Shih, Shyang–Rong; Hua, Cyue-Huei; Chuang, Lee‐Ming; Chen, Ming-Fong

doi:10.1111/j.1365-2265.2011.04129.x

Cited by 24 publications

(24 citation statements)

References 18 publications

(32 reference statements)

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“…Our results are consistent with previous studies that were performed in the Chinese general population [26], and also consistent with results from the non-diabetic population of a multi-ethnic atherosclerosis study [11] However, Haring et al [27] found a positive association between HbA1c and mean C-IMT, with a 0.02 mm increase in C-IMT per 1 % increase in HbA1, but this association did not remain in the longitudinal analysis.…”

Section: Discussionsupporting

confidence: 94%

Association between markers of glycemia and carotid intima-media thickness: the MARK study

Gómez‐Marcos

Gómez‐Sánchez²,

Patino-Alonso

et al. 2016

BMC Cardiovasc Disord

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BackgroundCarotid intima-media thickness (C-IMT) is a reliable predictor of cardiovascular events. We Investigated the relationship between markers of glycemia and C-IMT in intermediate-risk cardiovascular patients.MethodsThis study analyzed 427 subjects, aged 35 to 74 years (mean, 60.3 ± 8.5 years), 55 % women, enrolled into the MARK study. Including 231 subjects defined as normal glucose, 104 subjects classified as prediabetes and 92 with type 2 diabetes mellitus. Carotid ultrasound was used to measure C-IMT and the presence of plaques. Fasting plasma glucose (mg/dl) and glycated hemoglobin (%) (HbA1c) were measured using standard enzymatic automated methods. Postprandial glucose (mg/dl) was self-measured by patients at home 2 h after meals (breakfast, lunch and dinner) for 1 day.ResultsThe C-IMT shows a positive correlation with fasting plasma glucose, postprandial glucose and HbA1c. Multiple linear regression analysis showed a positive association between HbA1c and C-IMT, with a 0.016 mm and 0.019 mm increase in mean and maximum C-IMT per 1 % increase in HbA1c. In addition, an association between fasting plasma glucose and C-IMT was found with an increase of 0.004 and 0.005 mm in mean and maximum C-IMT per 10 mg/dl in fasting plasma glucose. We also observed a graded association between fasting plasma glucose, postprandial glucose and HbA1c and the presence of carotid target organ damage (TOD), with an odds ratio of 1.013, 1.010 and 1.425, respectively.ConclusionThe results of this study suggest that the fasting plasma glucose and HbA1c, but not postprandial glucose, are associated with C-IMT media and maximum. The patients who present with a metabolic glucose alteration have more risk of developing carotid TOD.Trial registrationClinicalTrials.gov; Identifier: NCT01428934.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0380-6) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 94%

Association between markers of glycemia and carotid intima-media thickness: the MARK study

Gómez‐Marcos

Gómez‐Sánchez²,

Patino-Alonso

et al. 2016

BMC Cardiovasc Disord

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“…The associations between hyperglycemia and CIMT were significant in univariate analyses, but disappeared after adjustment for age, sex and anthropometric variables. Furthermore, other studies have shown that higher HbA1c levels were significantly and independently related to increased CIMT, but IFG was not. Nevertheless, a positive association between FBG and CIMT was shown in previous studies.…”

Section: Discussionmentioning

confidence: 67%

Association between carotid intima‐media thickness and fasting blood glucose level: A population‐based cross‐sectional study among low‐income adults in rural China

Gao

Bai

Shi

et al. 2017

J of Diabetes Invest

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Aims/IntroductionCarotid intima‐media thickness (CIMT) is an established predictor of cardiovascular disease and stroke. We aimed to identify the association between CIMT and blood glucose, as well as the risk factors associated with increased CIMT in a low‐income Chinese population.Materials and MethodsStroke‐free and cardiovascular disease‐free residents aged ≥45 years were recruited. B‐mode ultrasonography was carried out to measure CIMT.ResultsThere were 2,643 participants (71.0%) in the normal group, 549 (14.7%) in the impaired fasting glucose group and 533 (14.3%) in the diabetes mellitus group. The determinants of increased CIMT were older age; male sex; low education; hypertension; smoking; high levels of systolic blood pressure, fasting blood glucose and low‐density lipoprotein cholesterol; and low levels of diastolic blood pressure, triglycerides and high‐density lipoprotein cholesterol, after adjusting for covariates. Age and hypertension were the common risk factors for increased CIMT in all three groups. Furthermore, male sex, smoking and high low‐density lipoprotein cholesterol level were positively associated with the mean CIMT in the normal group; high triglycerides levels were negatively associated with the mean CIMT in the impaired fasting glucose group; and alcohol consumption was an independent risk factor for mean CIMT in the diabetes mellitus group. Hypertension was the greatest risk factor for increased CIMT.ConclusionsThese findings suggest that it is crucial to manage and control traditional risk factors in low‐income populations in China in order to decelerate the recent dramatic increase in stroke incidence, and to reduce the burden of stroke.

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“…Sander et al 16 investigated 3534 elderly communitydwelling people (882 with diabetes and 2652 without diabetes) in Germany for an average follow-up of 2 years, and found that HbA1c was a predictor of atherosclerosis progression in both diabetic and non-diabetic populations. Additionally, Hung et al 17 found that HbA1c was significantly correlated with subclinical atherosclerosis in 541 Taiwan participants without a history of diabetes (67 of the 541 participants had been newly diagnosed with diabetes). Similarly, in the present study, HbA1c was identified as an independent risk factor for the increased C-IMT, which was also consistent with the results of studies above.…”

Section: Discussionmentioning

confidence: 99%

Associations of glycated haemoglobin A1c and glycated albumin with subclinical atherosclerosis in middle‐aged and elderly Chinese population with impaired glucose regulation

Shen

et al. 2015

Clin Exp Pharma Physio

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The aim of this study was to investigate the correlations of glycated haemoglobin A1c (HbA1c) and glycated albumin (GA) with subclinical atherosclerosis in middle-aged and elderly Chinese populations with impaired glucose regulation (IGR). In total, 640 subjects with IGR and no history of cardiovascular disease or carotid artery plaque were recruited for this study (256 men, 384 women; age range, 40-70 years). The carotid intima-media thickness (C-IMT) measured by carotid ultrasonography was used as an indicator of subclinical atherosclerosis. Increased C-IMT was defined as ≥ 0.70 mm (upper quartile). HbA1c and GA were measured with high-performance liquid chromatography and enzymatic method, respectively. The average HbA1c and GA among all 640 subjects were 5.7 ± 0.3% and 14.0 ± 1.1%, respectively. HbA1c and GA were higher in subjects with increased C-IMT than in subjects with normal C-IMT (5.8 ± 0.3% vs 5.7 ± 0.3% and 14.2 ± 1.0% vs 13.9 ± 1.1%, respectively; both P < 0.01). Correlation analysis showed that both HbA1c and GA were positively correlated with C-IMT (r = 0.135 and 0.112, respectively; both P < 0.01). Logistic regression analysis revealed that both HbA1c (odds ratio (OR), 2.630; 95% confidence interval (95% CI), 1.401-4.935; P = 0.003) and GA OR, 1.215; 95% CI, 1.008-1.466; P = 0.041) were independent risk factors for increased C-IMT. Both HbA1c and GA reflect the risk of subclinical atherosclerosis in middle-aged and elderly Chinese populations with IGR.

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Haemoglobin A1c is associated with carotid intima-media thickness in a Chinese population

Abstract: Thus, HbA1c level is associated with subclinical atherosclerosis in carotid arteries in a Chinese population. The relationship is linear without an inflection point. However, HbA1c criterion is not a useful marker for the identification of subclinical atherosclerosis.

Cited by 24 publications

References 18 publications

Association between markers of glycemia and carotid intima-media thickness: the MARK study

Association between markers of glycemia and carotid intima-media thickness: the MARK study

Association between carotid intima‐media thickness and fasting blood glucose level: A population‐based cross‐sectional study among low‐income adults in rural China

Associations of glycated haemoglobin A1c and glycated albumin with subclinical atherosclerosis in middle‐aged and elderly Chinese population with impaired glucose regulation

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