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Abstract
Background
Glycosylated hemoglobin (HbA1c) is a useful index of mean blood glucose concentrations over the preceding 2 to 3 months. Elevated HbA1c levels (> 7%) are associated with a higher incidence of microvascular and macrovascular complications in patients with diabetes mellitus. However, the relationship between HbA1c and cardiovascualr disease risk in nondiabetic adults has been unclear. The aim of this study is to estimate the association of HbA1c with cardiovascular disease risk factors and metabolic syndrome in nondiabetic adults.
Methods
The subjects of this study included 533 adults (180 males and 353 females) aged 20~70 years (mean age: 46.9 ± 10.12 years) without previously diagnosed diabetes who lived in Kangyang country. We examined baseline HbA1c levels and cardiovascular risk factors. Metabolic syndrome was defined based on International Diabetes Federation guidelines.
Results
The prevalence of metabolic syndrome significantly increased as HbA1c increased. HbA1c revealed a significant correlation with age (r = 0.258, P < 0.001), BMI (r = 0.152, P < 0.001), waist circumference (r = 0.252, P < 0.001), fasting plasma glucose (r = 0.319, P < 0.001), systolic (r = 0.100, P = 0.021), diastolic (r = 0.115, P = 0.008) blood pressure, total cholesterol (r = 0.232, P < 0.001), triglyceride (r = 0.156, P < 0.001), LDL cholesterol (r = 0.216, P < 0.001), and HDL cholesterol (r = -0.167, P < 0.001). Multiple regression analysis showed that HbA1c had a association with age, fasting plasma glucose, and dyslipidemia. The receiver operating characterstics (ROC) curve analysis determined HbA1c of 5.35% to yield optimal sensitivity and specificity corresponding to the presence of metabolic syndrome.
Figures and Tables
Table 1
Clinical characteristics of study subjects with respect to sex
Data are means ± SD. BMI, body mass index; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol; SBP, systolic blood pressure; TC, total cholesterol; WC, waist circumference. P values were obtained using the Student's t-test based on differences between male and female group.
Table 2
Comparison of cardiovascular risk factors of total study population according to quartile of HbA1c
*P < 0.05, for different from 1st, †P < 0.05, for different from 2nd, ‡P < 0.05, for different from 3rd. Data are means ± SD. BMI, body mass index; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol; SBP, systolic blood pressure; TC, total cholesterol; WC, waist circumference.
Table 3
Comparison of cardiovascular risk factors according to quartile of HbA1c by sex
*P < 0.05, for different from 1st, †P < 0.05, for different from 2nd, ‡P < 0.05, for different from 3rd. Data are means ± SD. BMI, body mass index; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol; SBP, systolic blood pressure; TC, total cholesterol; WC, waist circumference.
Table 4
Comparison of cardiovascular risk factors according to quartile of HbA1c by age
*P < 0.05, for different from 1st, †P < 0.05, for different from 2nd, ‡P < 0.05, for different from 3rd. Data are means ± SD. BMI, body mass index; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol; SBP, systolic blood pressure; TC, total cholesterol; WC, waist circumference.
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