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Article: Association between HbA1c and cardiovascular disease mortality in older Hong Kong Chinese with diabetes

TitleAssociation between HbA1c and cardiovascular disease mortality in older Hong Kong Chinese with diabetes
Authors
KeywordsCardiovascular disease
HbA 1c
Mortality
Issue Date2012
PublisherBlackwell Publishing Ltd.
Citation
Diabetic Medicine, 2012, v. 29 n. 3, p. 393-398 How to Cite?
AbstractObjective To examine the association between baseline HbA 1c level and mortality attributable to all-cause, cardiovascular disease, coronary heart disease and stroke. Methods A total of 2137 Chinese aged 65years or above attending the Elderly Health Service, Department of Health, Hong Kong, with diagnosed diabetes had HbA 1c measured during 1998 to 2000 and were followed up to 2009. Information on socio-economic position, lifestyle factors and disease history was collected. Hazard ratios and 95% confidence intervals with adjustment for potential confounders were calculated using Cox's proportional hazards models. Results After an average of 7.9years of follow-up, 540 participants had died. After adjusting for potential confounders, higher HbA 1c (≥69mmol/mol, 8.5%) increased the risk of cardiovascular disease (hazard ratio2.11;95%CI 1.37-3.25) and stroke mortality (hazard ratio2.43; 95%CI 1.06-5.55) compared with HbA 1c of 58-68mmol/mol (7.5-8.4%), and increased the risk of all-cause (hazard ratio1.41; 95%CI 1.06-1.86) and coronary heart disease mortality (hazard ratio2.44; 95%CI 1.11-5.37) compared with HbA 1c of 48mmol/mol (6.5%) or less. Analysis of HbA 1c as a continuous variable showed that every XXmmol/mol (1%) increase in HbA 1c decreased stroke mortality risk by 51% in those with HbA 1c level less than 48mmol/mol (6.5%) and increased stroke mortality risk by 30% in those with an HbA 1c level of 48mmol/mol (6.5%) or higher, suggesting a U-shaped association between HbA 1c and stroke mortality. Conclusion High HbA 1c predicted excess risk of all-cause, cardiovascular disease, coronary heart disease and stroke mortality. The question of whether low HbA 1c increases mortality in older patients with diabetes needs further investigation. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.
Persistent Identifierhttp://hdl.handle.net/10722/145978
ISSN
2015 Impact Factor: 3.152
2015 SCImago Journal Rankings: 1.654
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorXu, Len_US
dc.contributor.authorChan, WMen_US
dc.contributor.authorHui, YFen_US
dc.contributor.authorLam, THen_US
dc.date.accessioned2012-03-27T09:04:42Z-
dc.date.available2012-03-27T09:04:42Z-
dc.date.issued2012en_US
dc.identifier.citationDiabetic Medicine, 2012, v. 29 n. 3, p. 393-398en_US
dc.identifier.issn0742-3071-
dc.identifier.urihttp://hdl.handle.net/10722/145978-
dc.description.abstractObjective To examine the association between baseline HbA 1c level and mortality attributable to all-cause, cardiovascular disease, coronary heart disease and stroke. Methods A total of 2137 Chinese aged 65years or above attending the Elderly Health Service, Department of Health, Hong Kong, with diagnosed diabetes had HbA 1c measured during 1998 to 2000 and were followed up to 2009. Information on socio-economic position, lifestyle factors and disease history was collected. Hazard ratios and 95% confidence intervals with adjustment for potential confounders were calculated using Cox's proportional hazards models. Results After an average of 7.9years of follow-up, 540 participants had died. After adjusting for potential confounders, higher HbA 1c (≥69mmol/mol, 8.5%) increased the risk of cardiovascular disease (hazard ratio2.11;95%CI 1.37-3.25) and stroke mortality (hazard ratio2.43; 95%CI 1.06-5.55) compared with HbA 1c of 58-68mmol/mol (7.5-8.4%), and increased the risk of all-cause (hazard ratio1.41; 95%CI 1.06-1.86) and coronary heart disease mortality (hazard ratio2.44; 95%CI 1.11-5.37) compared with HbA 1c of 48mmol/mol (6.5%) or less. Analysis of HbA 1c as a continuous variable showed that every XXmmol/mol (1%) increase in HbA 1c decreased stroke mortality risk by 51% in those with HbA 1c level less than 48mmol/mol (6.5%) and increased stroke mortality risk by 30% in those with an HbA 1c level of 48mmol/mol (6.5%) or higher, suggesting a U-shaped association between HbA 1c and stroke mortality. Conclusion High HbA 1c predicted excess risk of all-cause, cardiovascular disease, coronary heart disease and stroke mortality. The question of whether low HbA 1c increases mortality in older patients with diabetes needs further investigation. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.-
dc.languageengen_US
dc.publisherBlackwell Publishing Ltd.-
dc.relation.ispartofDiabetic Medicineen_US
dc.rightsThe definitive version is available at www.blackwell-synergy.com-
dc.subjectCardiovascular disease-
dc.subjectHbA 1c-
dc.subjectMortality-
dc.subject.meshCardiovascular Diseases - blood - mortality-
dc.subject.meshDiabetes Mellitus, Type 1 - blood - mortality-
dc.subject.meshDiabetes Mellitus, Type 2 - blood - mortality-
dc.subject.meshHemoglobin A, Glycosylated - metabolism-
dc.subject.meshStroke - blood - mortality-
dc.titleAssociation between HbA1c and cardiovascular disease mortality in older Hong Kong Chinese with diabetesen_US
dc.typeArticleen_US
dc.identifier.emailLam, TH: hrmrlth@hkucc.hku.hken_US
dc.identifier.authorityLam, TH=rp00326en_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1464-5491.2011.03456.x-
dc.identifier.pmid21916977-
dc.identifier.scopuseid_2-s2.0-84863174647-
dc.identifier.hkuros198877en_US
dc.identifier.volume29en_US
dc.identifier.issue3en_US
dc.identifier.spage393en_US
dc.identifier.epage398en_US
dc.identifier.isiWOS:000300683800016-
dc.publisher.placeUnited Kingdom-

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