Aim We examined whether glycated haemoglobin (HbA1c) is associated to carotid atherosclerosis in an elderly Korean population with normal fasting glucose. Methods Using data from the Korean Urban Rural Elderly study, we conducted a cross-sectional analysis of 1,133 participants (335 men and 798 women) with a mean age of 71.8 years. All participants had fasting blood glucose less than 100mg/dL (5.6 mmol/L) and HbA1c level below 6.5% (48 mmol/mol). They were also free from a history of cardiovascular disease, known type 2 diabetes mellitus or use of anti-diabetes medications. Carotid atherosclerosis was assessed by intima-media thickness (IMT) using ultrasonography. The association between HbA1c and carotid IMT was investigated using multivariable linear regression analysis. Results HbA1c levels were independently and positively associated with carotid IMT (β = 0.020, p = 0.045) after adjusting for sex, age, body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, LDL cholesterol, smoking and alcohol intake. However, fasting insulin and glucose levels were not associated with carotid IMT. Conclusion HbA1c levels were positively associated with carotid atherosclerosis, as assessed by carotid IMT, in an elderly population with normoglycemia. Our study suggested that higher HbA1c level is an effective and informative marker of carotid atherosclerosis in an elderly population.
Bibliographical noteFunding Information:
This work was supported by the Korea Centers for Disease Control and Prevention (2012-E63001-001, 2013-E63007-00); and the Korean Health Technology RandD Project, Ministry of Health and Welfare, Korea (HI13C0715). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. SWL contributed to the study hypothesis, data collection, analysis and interpretation of the data, and wrote the first draft of the manuscript. HCK contributed to study hypothesis and design, data collection, analysis and interpretation of the data and reviewed a draft of the manuscript. YHL contributed to the interpretation of the data and reviewed a draft of the manuscript. BMS, HC and JHP contributed to data collection and discussion. YR and COK contributed to the study design, data collection, data analysis, and interpretation of the data. All authors reviewed the manuscript prior to submission.
© 2017 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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