Association of hemoglobin A 1c and glycated albumin with carotid atherosclerosis in community-dwelling Japanese subjects: the Hisayama Study

Cardiovascular Diabetology

Yutaka Kiyohara⁴  Takanari Kitazono¹  Dongchon Kang³  Udai Nakamura¹  Masafumi Koga²  Taeko Hotta³  Masayo Fukuhara¹  Fumie Ikeda¹  Yoichiro Hirakawa¹  Jun Hata¹  Toshiharu Ninomiya¹  Naoko Mukai¹ 

[1] Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan;Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan;Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

关键词: Carotid atherosclerosis;    2-hour postload glucose;    Fasting plasma glucose;    1,5-anhydroglucitol;    Glycated albumin;    Hemoglobin A1c;   

Others  :  1216824
DOI  :  10.1186/s12933-015-0247-7

 received in 2015-03-23, accepted in 2015-06-16,  发布年份 2015

【 摘 要 】

Background

It is not clear which glucose measure is more useful in the assessment of atherosclerosis. We investigated the associations of hemoglobin A _1c(HbA _1c ), glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), fasting plasma glucose (FPG), and 2-hour postload glucose (PG) with carotid intima-media thickness (IMT) in community-dwelling Japanese subjects.

Methods

A total of 2702 subjects aged 40–79 years underwent a 75-g oral glucose tolerance test and measurements of HbA _1c , GA, 1,5-AG, and carotid IMT by ultrasonography in 2007–2008. Carotid wall thickening was defined as a maximum IMT of >1.0 mm. The crude and multivariable-adjusted linear and logistic regression models were used to analyze cross-sectional associations between levels of glycemic measures and carotid IMT.

Results

The crude average of the maximum IMT increased significantly with rising quartiles of HbA _1c , GA, FPG, and 2-hour PG levels in subjects with and without glucose intolerance (GI), while no clear association was observed for 1,5-AG. After adjustment for other confounding factors, positive trends for HbA _1c , GA, and FPG (all p for trend < 0.05), but not 2-hour PG (p = 0.07) remained robust in subjects with GI, but no such associations were found in those without GI. When estimating multivariable-adjusted β values for the associations of 1 SD change in glycemic measures with the maximum IMT in subjects with GI, the magnitude of the influence of HbA _1c(β = 0.021), GA (β = 0.024), and FPG (β = 0.024) was larger than that of 2-hour PG (β = 0.014) and 1,5-AG (β = 0.003). The multivariable-adjusted odds ratios for the presence of carotid wall thickening increased significantly with elevating HbA _1c , GA, and FPG levels only in subjects with GI (all p for trend < 0.001). Among subjects with GI, the area under the receiver operating characteristic curve significantly increased by adding HbA _1c(p = 0.04) or GA (p = 0.04), but not 1,5-AG, FPG, or 2-hour PG, to the model including other cardiovascular risk factors.

Conclusions

In community-dwelling Japanese subjects with GI, elevated HbA _1c , GA, and FPG levels were significantly associated with increased carotid IMT, and HbA _1cand GA provided superior discrimination for carotid wall thickening compared to 1,5-AG, FPG, and 2-hour PG, suggesting that HbA _1cand GA are useful for assessing carotid atherosclerosis.

【 授权许可】

   
2015 Mukai et al.

【 图 表 】

Fig. 1.

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