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Glycated Hemoglobin Beats Glucose in Prognostic Value

Similarly predicts diabetes onset, more strongly predicts cardiovascular/mortality risk

WEDNESDAY, March 3 (HealthDay News) -- Glycated hemoglobin has a similar association with diabetes risk as fasting glucose, and it has a stronger association with cardiovascular disease and mortality risk, according to research published in the March 4 issue of the New England Journal of Medicine.

Elizabeth Selvin, Ph.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues analyzed data from 11,092 African-American or Caucasian adults with no history of diabetes or cardiovascular disease. Participants provided a blood sample at baseline and were followed for a median of 14 years.

The researchers found that, compared to glycated hemoglobin levels of 5 to less than 5.5, the adjusted hazard ratios for diagnosed diabetes were 0.52 for values less than 5 percent, 1.86 for 5.5 to less than 6 percent, 4.48 for 6 to less than 6.5 percent, and 16.47 for 6.5 percent or higher. Risk of coronary heart disease also increased with rising values (0.96 for values less than 5 percent to 1.95 for values of 6.5 percent or higher). Glycated hemoglobin and overall mortality followed a J-shaped association curve and the findings stayed significant after adjusting for baseline fasting glucose level. Fasting glucose levels were not significantly associated with cardiovascular or mortality risk after adjustment for covariates and glycated hemoglobin.

"In this community-based study population of black or white non-diabetic adults, glycated hemoglobin was superior to fasting glucose for assessment of the long-term risk of subsequent cardiovascular disease, especially at values above 6.0 percent. Such prognostic data may add to the evidence supporting the use of glycated hemoglobin as a diagnostic test for diabetes," the authors conclude.

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