TY - JOUR
T1 - Association of prediabetes by fasting glucose and/or haemoglobin A1c levels with subclinical atherosclerosis and impaired renal function
T2 - Observations from the Dallas Heart Study
AU - Xing, Frank Y F
AU - Neeland, Ian J
AU - Gore, M. Odette
AU - Ayers, Colby R.
AU - Paixao, Andre R M
AU - Turer, Aslan T
AU - Berry, Jarett D
AU - Khera, Amit
AU - de Lemos, James A
AU - McGuire, Darren K
N1 - Funding Information:
This work was supported by the National Center for Advancing Translational Sciences/National Institutes of Health and UT-STAR (UL1TR000451); US Public Health Service General Clinical Research Center (M01-RR00633) and National Institutes of Health (UL1DE019584, PL1DK081182). Grant support for the Dallas Heart Study was provided by the Donald W. Reynolds Foundation. This work was further supported by a grant from the Doris Duke Charitable Foundation to the University of Texas Southwestern Medical Center to fund Frank YF Xing, Clinical Research Fellow.
PY - 2014/1
Y1 - 2014/1
N2 - Background: Prediabetes defined by fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) predicts incident diabetes, but their individual and joint associations with micro- and macro-vascular risk remain poorly defined. Methods: FPG, HbA1c, coronary artery calcium (CAC), carotid wall thickness, estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) were measured in adults free from prior diabetes or cardiovascular disease (CVD) in the Dallas Heart Study 2 (DHS-2), a population-based cohort study. Prediabetes was defined by FPG 100.125 mg/dL and/or HbA1c 5.7%.6.4%. Multivariable logistic regression was used to analyse associations of HbA1c and/or FPG in the prediabetes range with subclinical atherosclerosis and renal measures. Results: The study comprised 2340 participants, median age = 49 years; 60% women and 50% black. Those with prediabetes were older (52 vs 48 years), more often men (63% vs 53%), black (53% vs 47%) and obese (58% vs 40%; p < 0.001 for each). Prediabetes was captured by FPG alone (43%), HbA1c alone (30%) or both (27%). Those with prediabetes by HbA1c or FPG versus normal HbA1c/FPG had more CAC [odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.5.2.2], higher carotid wall thickness (1.32 vs 1.29 mm, p < 0.001), eGFR < 60 mL/min [OR = 1.6 (95% CI = 1.1.2.4)], UACR > 30 mg/dL [OR = 1.8 (95% CI = 1.2.2.7)] and a higher odds for the composite eGFR + UACR [chronic kidney disease (CKD) ≥ 2] [OR = 1.9 (95% CI = 1.5.2.6)]. After multivariable adjustment, none of these associations remained significant. Conclusion: Prediabetes defined by HbA1c and/or FPG criteria is crudely associated with markers of diabetic macroand micro-vascular disease, but not after statistical adjustment, suggesting the relationships are attributable to other characteristics of the prediabetes population.
AB - Background: Prediabetes defined by fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) predicts incident diabetes, but their individual and joint associations with micro- and macro-vascular risk remain poorly defined. Methods: FPG, HbA1c, coronary artery calcium (CAC), carotid wall thickness, estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) were measured in adults free from prior diabetes or cardiovascular disease (CVD) in the Dallas Heart Study 2 (DHS-2), a population-based cohort study. Prediabetes was defined by FPG 100.125 mg/dL and/or HbA1c 5.7%.6.4%. Multivariable logistic regression was used to analyse associations of HbA1c and/or FPG in the prediabetes range with subclinical atherosclerosis and renal measures. Results: The study comprised 2340 participants, median age = 49 years; 60% women and 50% black. Those with prediabetes were older (52 vs 48 years), more often men (63% vs 53%), black (53% vs 47%) and obese (58% vs 40%; p < 0.001 for each). Prediabetes was captured by FPG alone (43%), HbA1c alone (30%) or both (27%). Those with prediabetes by HbA1c or FPG versus normal HbA1c/FPG had more CAC [odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.5.2.2], higher carotid wall thickness (1.32 vs 1.29 mm, p < 0.001), eGFR < 60 mL/min [OR = 1.6 (95% CI = 1.1.2.4)], UACR > 30 mg/dL [OR = 1.8 (95% CI = 1.2.2.7)] and a higher odds for the composite eGFR + UACR [chronic kidney disease (CKD) ≥ 2] [OR = 1.9 (95% CI = 1.5.2.6)]. After multivariable adjustment, none of these associations remained significant. Conclusion: Prediabetes defined by HbA1c and/or FPG criteria is crudely associated with markers of diabetic macroand micro-vascular disease, but not after statistical adjustment, suggesting the relationships are attributable to other characteristics of the prediabetes population.
KW - HbA1c
KW - impaired fasting glucose
KW - nephropathy
KW - prediabetes
KW - subclinical atherosclerosis
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U2 - 10.1177/1479164113514239
DO - 10.1177/1479164113514239
M3 - Article
C2 - 24344119
AN - SCOPUS:84890523860
SN - 1479-1641
VL - 11
SP - 11
EP - 18
JO - Diabetes and Vascular Disease Research
JF - Diabetes and Vascular Disease Research
IS - 1
ER -