Year: 2017
Type: article
Study design: Observational Study
Abstract: OBJECTIVE Hemoglobin A1c (HbA1c) can be used to assess type 2 diabetes (T2D) risk. We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability: 1) HbA1c alone, 2) fasting laboratory tests, 3) clinic data, and 4) fasting laboratory tests and clinic data. RESEARCH DESIGN AND METHODS We studied a prospective cohort of white (N = 11,244) and black (N = 2,294) middle-aged participants without diabetes in the Framingham Heart Study and Atherosclerosis Risk in Communities study. Association of HbA1c with incident T2D (defined by medication use or fasting glucose [FG] ≥126 mg/dL) was evaluated in regression models adjusted for 1) age and sex (demographics); 2) demographics, FG, HDL, and triglycerides; 3) demographics, BMI, blood pressure, and T2D family history; or 4) all preceding covariates. We combined results from cohort and race analyses by random-effects meta-analyses. Subsidiary analyses tested the association of HbA1c with developing T2D within 8 years or only after 8 years. RESULTS Over 20 years, 3,315 individuals developed T2D. With adjustment for demographics, the odds of T2D increased fourfold for each percentage-unit increase in HbA1c. The odds ratio (OR) was 4.00 (95% CI 3.14, 5.10) for blacks and 4.73 (3.10, 7.21) for whites, resulting in a combined OR of 4.50 (3.35, 6.03). After adjustment for fasting laboratory tests and clinic data, the combined OR was 2.68 (2.15, 3.34) over 20 years, 5.79 (2.51, 13.36) within 8 years, and 2.23 (1.94, 2.57) after 8 years. CONCLUSIONS HbA1c predicts T2D in different common scenarios and is useful for identifying individuals with elevated T2D risk in both the short- and long-term.
Source: Diabetes Care
DOI: 10.2337/dc17-0607
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G1052397333, G1135917780, G1243299691, G1460387277, G1527150935, G1691174148, G173303992, G1941623656, G250621538, G278200998, G2818629771, G301743239, G3042145041, G3114902838, G3152385821, G3405256882, G3410686264, G3462919067, G4167445418, G4200864717, G4443218670, G457330776, G4986752099, G5074086979, G5164707915, Research and Mentoring in the Clinical Epidemiology of Type 2 Diabetes, G5249188777, Epidemiology of Precursors to Type 2 Diabetes, G567847597, G6195637971, Diabetes and Prediabetes in Older Adults in ARIC, The Framingham Heart Study, G6548750934, G6552090923, G8683204365, G9000124674
OpenAlex ID: W2766577489