Association between increasing levels of hemoglobin A1c and coronary atherosclerosis in asymptomatic individuals without diabetes mellitus

Juan J. Rivera, Eue Keun Choi, Yeonyee E. Yoon, Eun Ju Chun, Sang Il Choi, Khurram Nasir, Frederick L. Brancati, Roger S. Blumenthal, Hyuk Jae Chang

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Earlier studies have shown an association between high-normal glucose and increasing glycosylated hemoglobin (HbA1c) levels and cardiovascular events. The objective of this investigation was to study the association between increasing levels of HbA1c in asymptomatic individuals without diabetes mellitus (DM) and coronary plaque characteristics. Methods: The study population consisted of 1043 asymptomatic Korean individuals without DM who underwent 64-slice cardiac computed tomography angiography as part of a health screening evaluation. We excluded 147 individuals with known history of DM and/or fasting glucose of at least 126 mg/dl, no HbA1c data, or missing risk factor information. The associations between coronary atherosclerosis and plaque subtype burden with increasing HbA1c levels were assessed using multivariable regression analyses. Results: The final study population consisted of 906 individuals without DM (mean age: 49±9 years, 62% males); 19 and 9% of the population had any and two or more segments with coronary plaque, respectively. Unadjusted analysis showed a positive association between increasing levels of HbA1c and the number of coronary segments with any (P<0.001) and with mixed coronary plaques (P<0.0001). The association persisted even when traditional risk factors were taken into account. No significant relationship was found between increasing HbA1c levels and the burden of noncalcified or calcified plaque. Conclusion: Increasing levels of HbA1c in asymptomatic individuals without DM are associated with the presence of coronary atherosclerosis, but more specifically with the presence and burden of mixed coronary plaques. Elements of plaque instability have been associated with mixed coronary plaques.

Original languageEnglish
Pages (from-to)157-163
Number of pages7
JournalCoronary artery disease
Volume21
Issue number3
DOIs
Publication statusPublished - 2010 May 1

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Coronary Artery Disease
Diabetes Mellitus
Hemoglobins
Population
Glucose
Glycosylated Hemoglobin A
Fasting
Regression Analysis
Health

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Rivera, Juan J. ; Choi, Eue Keun ; Yoon, Yeonyee E. ; Chun, Eun Ju ; Choi, Sang Il ; Nasir, Khurram ; Brancati, Frederick L. ; Blumenthal, Roger S. ; Chang, Hyuk Jae. / Association between increasing levels of hemoglobin A1c and coronary atherosclerosis in asymptomatic individuals without diabetes mellitus. In: Coronary artery disease. 2010 ; Vol. 21, No. 3. pp. 157-163.
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Association between increasing levels of hemoglobin A1c and coronary atherosclerosis in asymptomatic individuals without diabetes mellitus. / Rivera, Juan J.; Choi, Eue Keun; Yoon, Yeonyee E.; Chun, Eun Ju; Choi, Sang Il; Nasir, Khurram; Brancati, Frederick L.; Blumenthal, Roger S.; Chang, Hyuk Jae.

In: Coronary artery disease, Vol. 21, No. 3, 01.05.2010, p. 157-163.

Research output: Contribution to journalArticle

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T1 - Association between increasing levels of hemoglobin A1c and coronary atherosclerosis in asymptomatic individuals without diabetes mellitus

AU - Rivera, Juan J.

AU - Choi, Eue Keun

AU - Yoon, Yeonyee E.

AU - Chun, Eun Ju

AU - Choi, Sang Il

AU - Nasir, Khurram

AU - Brancati, Frederick L.

AU - Blumenthal, Roger S.

AU - Chang, Hyuk Jae

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Earlier studies have shown an association between high-normal glucose and increasing glycosylated hemoglobin (HbA1c) levels and cardiovascular events. The objective of this investigation was to study the association between increasing levels of HbA1c in asymptomatic individuals without diabetes mellitus (DM) and coronary plaque characteristics. Methods: The study population consisted of 1043 asymptomatic Korean individuals without DM who underwent 64-slice cardiac computed tomography angiography as part of a health screening evaluation. We excluded 147 individuals with known history of DM and/or fasting glucose of at least 126 mg/dl, no HbA1c data, or missing risk factor information. The associations between coronary atherosclerosis and plaque subtype burden with increasing HbA1c levels were assessed using multivariable regression analyses. Results: The final study population consisted of 906 individuals without DM (mean age: 49±9 years, 62% males); 19 and 9% of the population had any and two or more segments with coronary plaque, respectively. Unadjusted analysis showed a positive association between increasing levels of HbA1c and the number of coronary segments with any (P<0.001) and with mixed coronary plaques (P<0.0001). The association persisted even when traditional risk factors were taken into account. No significant relationship was found between increasing HbA1c levels and the burden of noncalcified or calcified plaque. Conclusion: Increasing levels of HbA1c in asymptomatic individuals without DM are associated with the presence of coronary atherosclerosis, but more specifically with the presence and burden of mixed coronary plaques. Elements of plaque instability have been associated with mixed coronary plaques.

AB - Background: Earlier studies have shown an association between high-normal glucose and increasing glycosylated hemoglobin (HbA1c) levels and cardiovascular events. The objective of this investigation was to study the association between increasing levels of HbA1c in asymptomatic individuals without diabetes mellitus (DM) and coronary plaque characteristics. Methods: The study population consisted of 1043 asymptomatic Korean individuals without DM who underwent 64-slice cardiac computed tomography angiography as part of a health screening evaluation. We excluded 147 individuals with known history of DM and/or fasting glucose of at least 126 mg/dl, no HbA1c data, or missing risk factor information. The associations between coronary atherosclerosis and plaque subtype burden with increasing HbA1c levels were assessed using multivariable regression analyses. Results: The final study population consisted of 906 individuals without DM (mean age: 49±9 years, 62% males); 19 and 9% of the population had any and two or more segments with coronary plaque, respectively. Unadjusted analysis showed a positive association between increasing levels of HbA1c and the number of coronary segments with any (P<0.001) and with mixed coronary plaques (P<0.0001). The association persisted even when traditional risk factors were taken into account. No significant relationship was found between increasing HbA1c levels and the burden of noncalcified or calcified plaque. Conclusion: Increasing levels of HbA1c in asymptomatic individuals without DM are associated with the presence of coronary atherosclerosis, but more specifically with the presence and burden of mixed coronary plaques. Elements of plaque instability have been associated with mixed coronary plaques.

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