Glycated hemoglobin levels, especially above 6.0%, are better than fasting glucose for predicting long-term cardiovascular risk, the New England Journal of Medicine reports.
Researchers measured glycated hemoglobin and fasting glucose in some 11,000 adults without diabetes or cardiovascular disease and followed them for a median of 14 years. Compared with hemoglobin levels of 5.0% to 5.5%, higher values — especially above 6% — were associated with significantly increased risks for diabetes, coronary heart disease, and stroke. Associations between hemoglobin and all-cause mortality were also significant, but formed a J-shaped curve, with the lowest and highest levels being predictive of death.
These findings held true even after adjustment for fasting glucose.
The authors say their findings "may add to the evidence supporting the use of glycated hemoglobin as a diagnostic test for diabetes."
A1c looks optimal at 5 ish percent (a,b,) and is a good predictor of cardiovascular risk (c)
ReplyDeletea-A1c concentrations less than 5% had the lowest rates of cardiovascular disease and mortality.Ann Intern Med. 2004 Sep 21;141(6):413-20.
b-A1C less than 4% increased mortalityLow hemoglobin A1c and risk of all-cause mortality among US adults without diabetes.
Carson AP, Fox CS, McGuire DK, Levitan EB, Laclaustra M, Mann DM, Muntner P.
Department of Epidemiology, University of Alabama at Birmingham, 35294-0022, USA. apcarson@uab.edu
c-Glycated Hemoglobin Better Than Fasting Glucose for Predicting Cardiovascular Risk