Young-Hoon Lee1, Min-Ho Shin2, Jin-Su Choi2, Jung-Ae Rhee2, Hae-Sung Nam3, Seul-Ki Jeong4, Kyeong-Soo Park5, So-Yeon Ryu6, Seong-Woo Choi6, Bok-Hee Kim7, Gyung-Jae Oh1, Sun-Seog Kweon8. 1. Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, South Korea; Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Jeonbuk, South Korea. 2. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea. 3. Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea. 4. Department of Neurology, Chonbuk National University Medical School-Chonbuk National University Hospital, Jeonju, Jeonbuk, South Korea. 5. Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Jeonbuk, South Korea. 6. Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea. 7. Department of Food & Nutrition, Chosun University College of Natural Sciences, Gwangju, South Korea. 8. Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea; Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea. Electronic address: ujingogo@paran.com.
Abstract
OBJECTIVES: We examined the associations between HbA1c levels and various atherosclerotic vascular parameters among adults without diabetes from the general population. METHODS: A total of 6500 community-dwelling adults, who were free of type 2 diabetes and ≥50 years of age, were included. High-resolution B-mode ultrasound was used to evaluate carotid artery structure, including intima-media thickness (IMT), plaque, and luminal diameter. Brachial-ankle pulse wave velocity (baPWV), which is a useful indicator of systemic arterial stiffness, was determined using an automatic waveform analysis device. RESULTS: No significant associations were observed between HbA1c, carotid IMT, plaque, or luminal diameter in a fully adjusted model. However, the odds ratio (95% confidence interval) for high baPWV (defined as the highest quartile) increased by 1.43 (1.19-1.71) per 1% HbA1c increase after adjusting for conventional risk factors in a multivariate logistic regression analysis. In addition, HbA1c was independently associated with baPWV in a multivariate linear regression analysis. CONCLUSIONS: High-normal HbA1c level was independently associated with arterial stiffness, but not with carotid atherosclerotic parameters, in the general population without diabetes. Our results suggest that the functional atherosclerotic process may already be accelerated according to HbA1c level, even at a level below the diagnostic threshold for diabetes.
OBJECTIVES: We examined the associations between HbA1c levels and various atherosclerotic vascular parameters among adults without diabetes from the general population. METHODS: A total of 6500 community-dwelling adults, who were free of type 2 diabetes and ≥50 years of age, were included. High-resolution B-mode ultrasound was used to evaluate carotid artery structure, including intima-media thickness (IMT), plaque, and luminal diameter. Brachial-ankle pulse wave velocity (baPWV), which is a useful indicator of systemic arterial stiffness, was determined using an automatic waveform analysis device. RESULTS: No significant associations were observed between HbA1c, carotid IMT, plaque, or luminal diameter in a fully adjusted model. However, the odds ratio (95% confidence interval) for high baPWV (defined as the highest quartile) increased by 1.43 (1.19-1.71) per 1% HbA1c increase after adjusting for conventional risk factors in a multivariate logistic regression analysis. In addition, HbA1c was independently associated with baPWV in a multivariate linear regression analysis. CONCLUSIONS: High-normal HbA1c level was independently associated with arterial stiffness, but not with carotid atherosclerotic parameters, in the general population without diabetes. Our results suggest that the functional atherosclerotic process may already be accelerated according to HbA1c level, even at a level below the diagnostic threshold for diabetes.
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