Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1 (5-Year IF – 2.0)
Journal Citation Indicator (JCI) (2023) – 0.4
Scopus CiteScore – 3.7 (CiteScore Tracker – 4.0)
Index Copernicus  – 171.00; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 5, May, p. 659–664

doi: 10.17219/acem/91790

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Age is the main determinant of glycated hemoglobin levels in a general Polish population without diabetes: The NATPOL 2011 Study

Bartosz Symonides1,B,C,D,E,F, Bogdan Solnica2,A,C,E,F, Grzegorz Placha1,B,E,F, Ewa Pędzich-Placha1,B,E,F, Marcin Rutkowski3,B,E,F, Piotr Bandosz3,B,E,F, Zbigniew Gaciong1,A,E,F, Tomasz Zdrojewski3,A,E

1 Department of Internal Medicine, Hypertension and Vascular Disease, Medical University of Warsaw, Poland

2 Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kraków, Poland

3 Department of Hypertension and Diabetology, Medical University of Gdańsk, Poland

Abstract

Background. Measurements of glycated hemoglobin (HbA1c) in non-diabetics can identify subjects who are at increased risk for future cardiovascular (CV) events. There is no consensus agreement whether the addition of HbA1c improves the CV risk prediction.
Objectives. The objective of this study was to assess mean values of HbA1c levels in a representative sample of general, diabetes mellitus (DM)-free Polish population, and its subgroups, and to identify important covariants.
Material and Methods. HbA1c was measured in blood samples collected from 1,868 participants (males/ females (M/F) 901/967, age: range 18–74, mean 44.03 years) of NATPOLL 2011 study without previously and newly diagnosed DM. Univariate and multivariate analyses of HbA1c level in relationship to age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), lipids, creatinine, C-reactive protein (CRP), gender, and smoking status were performed.
Results. Mean HbA1c level was 5.46 ±0.31% in the entire population and significantly higher levels were found in subjects with male gender, hypertension, fasting hyperglycemia, abdominal obesity, and higher BMI values but not in smokers. Univariate analysis revealed numerous significant correlations of HbA1c with the highest values correlation coefficient values for age (r = 0.55), FPG (r = 0.43), WC (r = 0.36), and BMI (r = 0.36). The best, final multivariate model explained 40% of HbA1c variance and the most important covariant was the age, explaining approx. 50% of R2, followed by FPG and BMI.
Conclusion. HbA1c in non-diabetic level is associated with certain CV risk factors, mainly with age. Since known risk factors explain less than a half of HbA1c variance, the inclusion of HbA1c into the assessment may increase the performance of algorithms predicting CV risk.

Key words

glycated hemoglobin, age, lipids

References (17)

  1. Pradhan AD, Rifai N, Buring JE, Ridker PM. Hemoglobin A1c predicts diabetes but not cardiovascular disease in nondiabetic women. Am J Med. 2007;120(8):720–727.
  2. Selvin E, Steffes MW, Zhu H, et al. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362(9):800–811.
  3. Khaw K-T, Wareham N, Bingham S, Luben R, Welch A, Day N. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: The European prospective investigation into cancer in Norfolk. Ann Intern Med. 2004;141(6):413–420.
  4. Seino Y, Nanjo K, Tajima N, et al. Report of Committee on the Classification and Diagnostic Criteria of Diabetes Mellitus. J Diabetes Investig. 2010;1:(5)212–228.
  5. Matsushita K, Blecker S, Pazin-Filho A, et al. The association of hemoglobin a1c with incident heart failure among people without diabetes: The atherosclerosis risk in communities study. Diabetes. 2010;59(8):2020–2026.
  6. Jansen H, Stolk RP, Nolte IM, Kema IP, Wolffenbuttel BHR, Snieder H. Determinants of HbA1c in nondiabetic Dutch adults: Genetic loci and clinical and lifestyle parameters, and their interactions in the Lifelines Cohort Study. J Intern Med. 2013;273(3):283–293.
  7. Sarwar N, Aspelund T, Eiriksdottir G, et al. Markers of dysglycaemia and risk of coronary heart disease in people without diabetes: Reykjavik prospective study and systematic review. PLoS Med. 2010;7(5):e1000278.
  8. Gerstein HC, Islam S, Anand S, et al. Dysglycaemia and the risk of acute myocardial infarction in multiple ethnic groups: An analysis of 15,780 patients from the INTERHEART study. Diabetologia. 2010;53(12):2509–2517.
  9. Preiss D, Sattar N. HbA1c: A useful cardiovascular risk marker in those without diabetes? Diabetologia. 2010;53(12):2468–2469.
  10. Rutkowski M, Bandosz P, Czupryniak L, et al. Prevalence of diabetes and impaired fasting glucose in Poland: The NATPOL 2011 Study. Diabet Med. 2014;31(12):1568–1571.
  11. Fizelova M, Stancakova A, Lorenzo C, et al. Glycated hemoglobin levels are mostly dependent on nonglycemic parameters in 9398 Finnish men without diabetes. J Clin Endocrinol Metab. 2015;100(5):1989–1996.
  12. van ‘t Riet E, Alssema M, Rijkelijkhuizen JM, Kostense PJ, Nijpels G, Dekker JM. Relationship between A1C and glucose levels in the general Dutch population: The new Hoorn study. Diabetes Care. 2010;33(1):61–66.
  13. Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, McDonald JM, Parrott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem. 2002;48(3):436–472.
  14. Pani LN, Korenda L, Meigs JB, et al. Effect of aging on A1C levels in individuals without diabetes: Evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001–2004. Diabetes Care. 2008;31(10):1991–1996.
  15. Soranzo N, Sanna S, Wheeler E, et al. Common variants at 10 genomic loci influence hemoglobin A1(c) levels via glycemic and nonglycemic pathways. Diabetes. 2010;59(12):3229–3239.
  16. Davidson MB, Schriger DL. Effect of age and race/ethnicity on HbA1c levels in people without known diabetes mellitus: Implications for the diagnosis of diabetes. Diabetes Res Clin Pract. 2010;87(3):415–421.
  17. Haring R, Baumeister SE, Lieb W, et al. Glycated hemoglobin as a marker of subclinical atherosclerosis and cardiac remodeling among non-diabetic adults from the general population. Diabetes Res Clin Pract. 2014;105(3):416–423.