HbA1c and fasting plasma glucose levels are equally related to incident cardiovascular risk in a high CVD risk population without known diabetes.
Diagnosis (Berl)
; 11(3): 312-320, 2024 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-38414181
ABSTRACT
OBJECTIVES:
Type 2 diabetes (T2DM) is associated with increased risk for cardiovascular disease (CVD). Whether screen-detected T2DM, based on fasting plasma glucose (FPG) or on HbA1c, are associated with different risks of incident CVD in high-risk populations and which one is preferable for diabetes screening in these populations, remains unclear.METHODS:
A total of 8,274 high-risk CVD participants were included from the UCC-SMART cohort. Participants were divided into groups based on prior T2DM diagnosis, and combinations of elevated/non-elevated FPG and HbA1c (cut-offs at 7â¯mmol/L and 48â¯mmol/mol, respectively) Group 0 known T2DM; group 1 elevated FPG/HbA1c; group 2 elevated FPG, non-elevated HbA1c; group 3 non-elevated FPG, elevated HbA1c; group 1 + 2 elevated FPG, regardless of HbA1c; group 1 + 3 elevated HbA1c, regardless of FPG; and group 4 (reference), non-elevated FPG/HbA1c.RESULTS:
During a median follow-up of 6.3â¯years (IQR 3.3-9.8), 712 cardiovascular events occurred. Compared to the reference (group 4), group 0 was at increased risk (HR 1.40; 95â¯% CI 1.16-1.68), but group 1 (HR 1.16; 95â¯% CI 0.62-2.18), 2 (HR 1.18; 95 % CI 0.84-1.67), 3 (HR 0.61; 95â¯% CI 0.15-2.44), 1 + 2 (HR 1.17; 95 % CI 0.86-1.59) and 1 + 3 (HR 1.01; 95â¯% CI 0.57-1.79) were not. However, spline interpolation showed a linearly increasing risk with increasing HbA1c/FPG, but did not allow for identification of other cut-off points.CONCLUSIONS:
Based on current cut-offs, FPG and HbA1c at screening were equally related to incident CVD in high-risk populations without known T2DM. Hence, neither FPG, nor HbA1c, is preferential for diabetes screening in this population with respect to risk of incident CVD.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Glicemia
/
Hemoglobinas Glicadas
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Doenças Cardiovasculares
/
Jejum
/
Diabetes Mellitus Tipo 2
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Diagnosis (Berl)
/
Diagnosis (Berl., Internet)
/
Diagnosis (Berlin. Internet)
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Holanda
País de publicação:
Alemanha