Hemoglobin A1c Levels and Aortic Arterial Stiffness: The Cardiometabolic Risk in Chinese (CRC) Study
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CitationLiang, Jun, Na Zhou, Fei Teng, Caiyan Zou, Ying Xue, Manqing Yang, Huaidong Song, and Lu Qi. 2012. Hemoglobin A1c levels and aortic arterial stiffness: The Cardiometabolic Risk in Chinese (CRC) study. PLoS ONE 7(8):e38485.
AbstractObjective: The American Diabetes Association (ADA) recently published new clinical guidelines in which hemoglobin A1c (HbA1c) was recommended as a diagnostic test for diabetes. The present study was to investigate the association between HbA1c and cardiovascular risk, and compare the associations with fasting glucose and 2-hour oral glucose tolerance test (2 h OGTT). Research design and methods: The study samples are from a community-based health examination survey in central China. Carotid-to-femoral pulse wave velocity (cfPWV) and HbA1c were measured in 5,098 men and women. Results: After adjustment for age, sex, and BMI, the levels of HbA1c were significantly associated with an increasing trend of cfPWV in a dose-dependent fashion (P for trend <0.0001). The associations remained significant after further adjustment for blood pressure, heart rate, and lipids (P = 0.004), and the difference in cfPWV between the highest and the lowest quintiles of HbA1c was 0.31 m/s. Fasting glucose and 2 h OGTT were not associated with cfPWV in the multivariate analyses. HbA1c showed additive effects with fasting glucose or 2 h OGTT on cfPWV. In addition, age and blood pressure significantly modified the associations between HbA1c and cfPWV (P for interactions <0.0001 for age; and = 0.019 for blood pressure). The associations were stronger in subjects who were older \((\geq60 y; P for trend = 0.004)\) and had higher blood pressure \((\geq 120 [systolic blood pressure]/80 mmHg [diastolic blood pressure]; P for trend = 0.028)\) than those who were younger and had lower blood pressure (P for trend >0.05). Conclusions: HbA1c was related to high cfPWV, independent of conventional cardiovascular risk factors. Senior age and high blood pressure might amplify the adverse effects of HbA1c on cardiovascular risk.
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