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Association of glyc...
Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population : results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium
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- Sinning, Christoph (author)
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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- Makarova, Nataliya (author)
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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- Völzke, Henry (author)
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
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- Schnabel, Renate B. (author)
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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- Ojeda, Francisco (author)
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
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- Dörr, Marcus (author)
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany; Department of Internal Medicine B, University of Medicine Greifswald, Greifswald, Germany
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- Felix, Stephan B. (author)
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany; Department of Internal Medicine B, University of Medicine Greifswald, Greifswald, Germany
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- Koenig, Wolfgang (author)
- German Heart Center Munich, Technical University, Munich, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany; Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
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- Peters, Annette (author)
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
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- Rathmann, Wolfgang (author)
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
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- Schöttker, Ben (author)
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany
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- Brenner, Hermann (author)
- Division of Clinical Epidemiology and Ageing Research, German Cancer Research Center, Heidelberg, Germany; Network Aging Research, University of Heidelberg, Heidelberg, Germany
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- Veronesi, Giovanni (author)
- Department of Medicine and Surgery, EPIMED Research Center, University of Insubria at Varese, Varese, Italy
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- Cesana, Giancarlo (author)
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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- Brambilla, Paolo (author)
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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- Palosaari, Tarja (author)
- Finnish Institute for Health and Welfare, Division Public Health and Welfare, Helsinki, Finland
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- Kuulasmaa, Kari (author)
- Finnish Institute for Health and Welfare, Division Public Health and Welfare, Helsinki, Finland
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- Njølstad, Inger (author)
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsö, Norway
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- Bøgeberg Mathiesen, Ellisiv (author)
- Brain and Circulation Research Group, UiT The Arctic University of Norway, Tromsö, Norway; Neurological Department, University Hospital of North Norway, Tromsö, Norway
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- Wilsgaard, Tom (author)
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsö, Norway
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- Blankenberg, Stefan (author)
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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- Söderberg, Stefan (author)
- Umeå universitet,Avdelningen för medicin
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- Ferrario, Marco M. (author)
- Department of Medicine and Surgery, EPIMED Research Center, University of Insubria at Varese, Varese, Italy
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- Thorand, Barbara (author)
- German Research Center for Environmental Health, Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; German Center for Diabetes Research (DZD), Munich, Neuherberg, Germany
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(creator_code:org_t)
- 2021-11-15
- 2021
- English.
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In: Cardiovascular Diabetology. - : BioMed Central. - 1475-2840. ; 20:1
- Related links:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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Abstract
Subject headings
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- Background: Biomarkers may contribute to improved cardiovascular risk estimation. Glycated hemoglobin A1c (HbA1c) is used to monitor the quality of diabetes treatment. Its strength of association with cardiovascular outcomes in the general population remains uncertain. This study aims to assess the association of HbA1c with cardiovascular outcomes in the general population.Methods: Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analyzed. HbA1c was evaluated in conjunction with classical cardiovascular risk factors (CVRFs) for association with cardiovascular mortality, cardiovascular disease (CVD) incidence, and overall mortality in subjects without diabetes (N = 32,496) and with diabetes (N = 3684).Results: Kaplan–Meier curves showed higher event rates with increasing HbA1c levels (log-rank-test: p < 0.001). Cox regression analysis revealed significant associations between HbA1c (in mmol/mol) in the total study population and the examined outcomes. Thus, a hazard ratio (HR) of 1.16 (95% confidence interval (CI) 1.02–1.31, p = 0.02) for cardiovascular mortality, 1.13 (95% CI 1.03–1.24, p = 0.01) for CVD incidence, and 1.09 (95% CI 1.02–1.17, p = 0.01) for overall mortality was observed per 10 mmol/mol increase in HbA1c. The association with CVD incidence and overall mortality was also observed in study participants without diabetes with increased HbA1c levels (HR 1.12; 95% CI 1.01–1.25, p = 0.04) and HR 1.10; 95% CI 1.01–1.20, p = 0.02) respectively. HbA1c cut-off values of 39.9 mmol/mol (5.8%), 36.6 mmol/mol (5.5%), and 38.8 mmol/mol (5.7%) for cardiovascular mortality, CVD incidence, and overall mortality, showed also an increased risk.Conclusions: HbA1c is independently associated with cardiovascular mortality, overall mortality and cardiovascular disease in the general European population. A mostly monotonically increasing relationship was observed between HbA1c levels and outcomes. Elevated HbA1c levels were associated with cardiovascular disease incidence and overall mortality in participants without diabetes underlining the importance of HbA1c levels in the overall population.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe)
- Biomarkers
- Cardiovascular risk
- Glycated hemoglobin A1c (HbA1c)
- MORGAM (MONICA Risk Genetics Archiving and Monograph)
- Mortality
Publication and Content Type
- ref (subject category)
- art (subject category)
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Sinning, Christo ...
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Makarova, Natali ...
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Völzke, Henry
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Schnabel, Renate ...
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Ojeda, Francisco
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Dörr, Marcus
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show more...
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Felix, Stephan B ...
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Koenig, Wolfgang
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Peters, Annette
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Rathmann, Wolfga ...
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Schöttker, Ben
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Brenner, Hermann
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Veronesi, Giovan ...
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Cesana, Giancarl ...
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Brambilla, Paolo
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Palosaari, Tarja
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Kuulasmaa, Kari
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Njølstad, Inger
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Bøgeberg Mathies ...
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Wilsgaard, Tom
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Blankenberg, Ste ...
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Söderberg, Stefa ...
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Ferrario, Marco ...
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Thorand, Barbara
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MEDICAL AND HEAL ...
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and Endocrinology an ...
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MEDICAL AND HEAL ...
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Cardiovascular D ...
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Umeå University