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03-03-2010 | Diabetes | Article

HbA1c better predictor for CVD than fasting plasma glucose

Abstract

Free abstract

MedWire News: Glycated hemoglobin (HbA1c) is a better predictor for cardiovascular disease (CVD) and death than fasting plasma glucose (FPG), report researchers.

HbA1c and FPG were similarly predictive for Type 2 diabetes, however.

FPG measurement is currently used to diagnose diabetes in the USA, but HbA1c measurement has been suggested to be a suitable alternative, say researchers.

For this study, Elizabeth Selvin (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA) and colleagues compared the two methods by measuring the HbA1c of 11,092 stored blood samples, taken in 1990–1992, from adults who participated in the Atherosclerosis Risk in Communities (ARIC) study. FPG measures were previously recorded.

Participants were followed-up for a median period of 14 years for incident diabetes, CVD (coronary heart disease [CHD] and/or stroke), and death.

Writing in the New England Journal of Medicine, the researchers report that a baseline HbA1c of 5.5–6.0%, 6.0–6.5%, and 6.5% or more increased the risk for Type 2 diabetes 1.86-, 4.48-, and 16.47-fold, respectively. These values agreed with the risk as predicted by FPG levels.

A baseline HbA1c of 5.5–6.0%, 6.0–6.5%, and 6.5% or more also predicted an increased CHD risk of 1.23-, 1.78-, and 1.95-fold, respectively, with similar increases in risk observed for stroke. But, the team notes that FPG measures did not significantly predict CVD risk.

HbA1c had a J-shaped association with mortality with the lowest mortality seen in the 5.0–5.5% group.

“In this community-based study population of Black or White nondiabetic adults, glycated hemoglobin was superior to fasting glucose for assessment of the long-term risk of subsequent CVD, especially at values above 6.0%,” conclude Selvin and co-authors.

“Such prognostic data may add to the evidence supporting the use of glycated hemoglobin as a diagnostic test for diabetes,” they add.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert