scholarly journals Prospective study of hemoglobin A1c and incident carotid artery plaque in Chinese adults without diabetes

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Renying Xu ◽  
Ting Zhang ◽  
Yanping Wan ◽  
Zhuping Fan ◽  
Xiang Gao
Keyword(s):  
Blood Glucose ◽  
Carotid Artery ◽  
Hba1c Level ◽  
Hemoglobin A1c ◽  
Proportional Hazards Model ◽  
Fasting Blood Glucose ◽  
Cox Proportional Hazards Model ◽  
Baseline Hba1c ◽  
Chinese Adults ◽  
Carotid Artery Plaque

Abstract Background Diabetes has been reported to be associated with carotid artery plaque (CAP). However, it remains unclear whether hemoglobin A1c (HbA1c) level, a marker for long-term glycemic status, is associated with altered CAP risk in individuals with fasting blood glucose (FBG) concentrations below the current cutoff for diabetes. Methods Included were 16,863 Chinese adults (aged 18 years or more; 9855 men and 7008 women) with fasting blood glucose < 7.0 mmol/L at baseline (2013). Both HbA1c level and CAP (assessed via ultrasound B-mode imaging) were annually assessed during 2014–2018. All the participants were further classified into three groups based on baseline HbA1c level: ≤ 5.6%, 5.7–6.4%, and ≥ 6.5%. We used Cox proportional-hazards model to evaluate the association between HbA1c level and incident CAP, adjusting for a series of potential confounders. Results During 5 years of follow up, 3942 incident CAP cases were identified. Individuals with higher baseline HbA1c had higher future risk of CAP (p-trend < 0.001). In the full-adjusted model, each percent increase of HbA1c was associated with a 56% (HR = 1.56, 95% CI 1.37, 1.78) higher risk of CAP. Excluding participants with chronic inflammation, as assessed by high-sensitivity C-reactive protein and white blood cell, and those with FBG ≥ 5.6 mmol/L at baseline generated similar results. Conclusions Elevated HbA1c level was associated with high risk of developing CAP in Chinese adults without FBG defined diabetes.

Abstract TP208: 1,5-anhydro-d-glucitol as a Predictor of Cerebral Infarction in Patients With Glycated Hemoglobin A1c-based Good Diabetes Control

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Yuji Shiga ◽  
Yuhei Kanaya ◽  
Shinichi Takeshima ◽  
Yasunori Fujikawa ◽  
Kazuhiro Takamatsu ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cerebral Infarction ◽  
Hba1c Level ◽  
Hemoglobin A1c ◽  
Glycated Hemoglobin ◽  
Glycemic Variability ◽  
Diabetes Control ◽  
Short Term ◽  
High Group ◽  
Glycated Hemoglobin A1c

Introduction: Current guidelines set the goal of diabetes control to a glycated hemoglobin A1c (HbA1c) level of <7% in order to prevent macrovascular events. However, we often experience diabetes patients with cerebral infarction (CI), even though their HbA1c level is well-controlled. A reason for this disparity between the diabetes control status and CI onset may be the limitation of HbA1c as a diabetes control indicator. HbA1c reflects the mean blood glucose level over the past 2-3 months. Therefore, with HbA1c, we cannot evaluate short-term blood glucose control and glycemic variability, which are reported as risk factors for CI. Measurement of 1,5-anhydro-D-glucitol (1,5AG) allows the evaluation of these factors. Hypothesis: 1,5AG can be used to evaluate the risk of CI in patients with well-controlled diabetes. Methods: We retrospectively reviewed the medical records of 1169 patients with diabetes who received treatment for CI at our hospital between 2009 and 2014. These patients were divided into the following two groups according to their HbA1c-based diabetes control status: a CI-low group (HbA1c <7%, n=549) and a CI-high group (HbA1c ≧7%, n=620). We also included a non-CI group of 394 diabetes patients without CI (control group), and these patients were further divided into the following two groups in the same manner: a nonCI-low group (n=199) and a nonCI-high group (n=195). The 1,5AG levels were compared between the CI-low and nonCI-low groups, and the CI-high and nonCI-high groups. Results: There was no difference in the 1,5AG level between the CI-high and nonCI-high groups (8.8±7.3% vs. 8.9±7.1%, p=0.83). However, the 1,5AG level was significantly lower in the CI-low group than in the nonCI-low group (12.5±8.1% vs. 15.2±8.8%, p<0.001). This difference remained significant after adjusting for age and sex. Conclusion: The results of this study show that short-term glycemic control and glycemic variability have a significant relationship with existing CI especially in patients with good diabetes control. The 1,5AG level may be a surrogate measure of the risk of CI in patients with HbA1c levels that indicate good diabetes control.

scholarly journals Penggunaan Insulin Basal dalam Praktek Sehari-hari: Panduan Praktis untuk Dokter Umum

2017 ◽  
Vol 8 (2) ◽  
pp. 53
Author(s):  
Dani Rosdiana
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Sugar ◽  
Basal Insulin ◽  
Hba1c Level ◽  
Blood Sugar Level ◽  
Fasting Blood Glucose ◽  
Effective Agent ◽  
Best Parameter ◽  
Prevalence Of Diabetes Mellitus

Prevalence of diabetes mellitus in Riau have reached 10,4 %, it’s higher than national pravelence. Hence, it’s needmore attention from physician. The important thing in managing DM is how to restrain controlled blood sugar level.The best parameter to evaluate controlled blood sugar level is level of HbA1c. Fasting blood glucose is one ofimportant component which determine HbA1c especially HbA1c more than 8,5%. There are some pharmacologyagent to decrease HbA1c level, and insulin is the most effective agent. Why physician needs insulin?It was caused by impairment of betha cell pancreas was directly propotional with DM progressiveness. Comprehensionand capability for using basal insulin are important to physician, not only for internist but also for general practinioner.As we know that general practinioner have a competency to manage DM without complication. Guidance for usingsimple and practical basal insulin is expected will facilitate physician to manage blood sugar level of DM patient.

Abstract P105: Greater 24 Hour Blood Pressure Variability is Associated With Higher 24 Hour Systolic Blood Pressure and Glucose Independent of Age and Large Elastic Artery Stiffness in Normotensive Adults

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Lyndsey E DuBose ◽  
Seth W Holwerda ◽  
Amy K Stroud ◽  
Nealy A Wooldridge ◽  
Janie E Myers ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Blood Glucose ◽  
Carotid Artery ◽  
Linear Regression ◽  
Fasting Blood Glucose ◽  
Large Artery ◽  
Stepwise Linear Regression ◽  
Artery Stiffness ◽  
Elastic Artery

Older age is associated with elevated large elastic artery stiffness, a strong predictor of cardiovascular (CVD) risk in middle-age/older (MA/O) adults independent of blood pressure (BP). Greater 24-hour systolic BP variability (BPV) is also an independent risk factor for CVD and is linked to large artery stiffness in MA/O adults with hypertension and diabetes. However, its relation to age-related arterial stiffness in adults with low risk factor burden is unclear. We hypothesized that higher systolic BPV would be: 1) associated with advancing age, and 2) related to elevated aortic and carotid artery stiffness among healthy MA/O adults. To determine this, 98 healthy adults (ages 19-70 yrs) with measurements of systolic BPV (standard deviation of 24 hr systolic BP) via ambulatory BP monitoring, aortic stiffness (carotid-femoral pulse wave velocity, cfPWV), carotid artery stiffness (β-stiffness via carotid tonometry/B mode ultrasound) and circulating metabolic factors were included. In the entire cohort, greater systolic BPV was not associated with age, cfPWV, carotid β stiffness or circulating lipids/glucose (all P>0.05), but was correlated (age-adjusted) with 24 hr systolic BP (r= 0.41, P<0.001) and BMI (r= 0.21, P<0.05). In stepwise linear regression analyses that included age, sex, BMI, only 24 hr systolic BP was associated with systolic BPV (β= 0.14 ± 0.03, Model R 2 = 0.20, P< 0.001). Interestingly, there was no difference in 24 hr systolic BPV (11.4 ± 0.4 vs 11.4 ± 0.5 SD mmHg, P=0.99) in young (n=55; 29.0 ± 0.7 yrs) vs. MA/O (n= 43; 53.0 ± 1.2 yrs) adults despite higher cfPWV (594 ± 12 vs 913 ± 39 cm/sec, P<0.001), carotid β-stiffness (6.8 ± 0.6 vs 9.3 ±0.9 U, P=0.001) and 24 hr systolic BP (121 ± 1 vs 125 ± 2 mmHg, P<0.05). Systolic BPV was associated with BMI (r= 0.42, p< 0.01) and fasting blood glucose (r= 0.54, P= 0.001) in MA/O but not young adults. In a stepwise linear regression model among MA/O, 24 hr systolic BP (β= 0.18 ± 0.04, R 2 = 0.36, P<0.001) and fasting glucose (β= 0.10 ± 0.05, R 2 change= 0.07, P<0.001) were the only significant correlates of systolic BPV (Model R 2 = 0.43, P<0.001). In conclusion, 24 hr systolic BP and fasting blood glucose, but not age or large elastic artery stiffness, were the strongest determinants of higher systolic BPV in normotensive MA/O adults.

scholarly journals Lack of Associations between Elevated Serum Uric Acid and Components of Metabolic Syndrome Such as Hypertension, Dyslipidemia, and T2DM in Overweight and Obese Chinese Adults

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Li Li ◽  
Qifa Song ◽  
Xi Yang
Keyword(s):  
Metabolic Syndrome ◽  
Uric Acid ◽  
Blood Glucose ◽  
Serum Uric Acid ◽  
Muscle Mass ◽  
Alanine Aminotransferase ◽  
Glycosylated Hemoglobin ◽  
Fasting Blood Glucose ◽  
Elevated Serum ◽  
Chinese Adults

The overweight and obese population experiences a higher occurrence of both hyperuricemia and metabolic syndrome. The present study was to explore the relationship between serum uric acid and metabolic syndrome-related risk factors among 409 obese Chinese adults (254 women and 155 men) with >24 kg/m2 BMI. Based on sex-specific reference ranges, 233 (57%) patients showed elevated serum uric acid. A total of 15 attributes were selected to assess the associations between elevated serum uric acid and components of metabolic syndrome, including serum uric acid, total cholesterol, HDL-C, LDL-C, triglyceride, systolic blood pressure, fasting blood glucose, glycosylated hemoglobin, HOMA-IR, alanine aminotransferase, creatinine, urine microalbumin, muscle mass amount, BMI, and age. Among the participants stratified into three groups of grade I, grade II, and grade III obesity, as well as among the participants stratified into male and female groups, univariate correlation analysis identified a negative association (P<0.01) for age, positive associations (P<0.01) for BMI, muscle mass, alanine aminotransferase, and creatinine. The stepwise multivariate logistic regression proved similar associations for age, BMI, creatinine, and alanine aminotransferase. No significant associations were testified between serum uric acid levels and cholesterol, HDL-C, LDL-C, triglyceride, fasting blood glucose, glycosylated hemoglobin, HOMA-IR, and urine microalbumin. Factor analysis illustrated that 15 attributes could be grouped into two common factors and five individual factors. A common underlying factor was identified among uric acid, muscle mass, creatinine, alanine aminotransferase, and BMI. The results indicate that serum uric acid has no apparent association with metabolic syndromes that are commonly characterized by hypertension, dyslipidemia, and T2DM.

scholarly journals A bőr-autofluoreszcencia és a konvencionális glykaemiás markerek kapcsolata diabeteses betegekben

2015 ◽  
Vol 156 (33) ◽  
pp. 1341-1347
Author(s):  
Emília Mácsai ◽  
Erika Rakk ◽  
Margit Miléder ◽  
Ágnes Fulcz
Keyword(s):  
Blood Glucose ◽  
Hemoglobin A1c ◽  
Fasting Blood Glucose ◽  
Glycemic Load ◽  
Vascular Complications ◽  
Rank Test ◽  
Accurate Estimation ◽  
Skin Autofluorescence ◽  
Before And After ◽  
Patients With Diabetes

Introduction: Skin autofluorescence has a well-known significance for screening diabetes and early diagnosis of vascular complications. It predicts cardiovascular events better than hemoglobin A1c, hence skin autofluorescence is a marker of cumulative tissue glycemic load whereas hemoglobin A1c reflects changes occurring in the previous 6–8 weeks. Aim: The aim of the authors was analyze the relationship between skin autofluorescence and conventional glycemic markers in patients with diabetes. Method: Skin autofluorescence measurements were performed in 2010 in 18 patients (10 men and 8 women with normal glomerular filtration rate; age, 61.4±13.8 years) with long term follow-up (2624 months, 476 laboratory results). Relationships between skin autofluorescence values and fasting blood glucose, hemoglobin A1c levels and metabolic parameters obtained before and after skin autofluorescence measurements were analysed using Spearman rank test. Results: The average skin autofluorescence value was 2.88±0.65 arbitrary units. There were no significant correlations between skin autofluorescence and hemoglobin A1c levels obtained before (7.84±1.08%, p = 0.07) and after the skin autofluorescence measurements (7.45±1.18%, p = 0.71). Skin autofluorescence values also failed to show relationship with fasting blood glucose obtained before (p = 0.09) and after (p = 0.29) the skin autofluorescence measurements. Conclusions: In patients with diabetes skin autofluorescence may provide novel information about glycemic burden. Skin autofluorescence values (which may presumably provide a more accurate estimation of the cardiovascular risk) do not correlate with hemoglobin A1c and fasting blood glucose. Orv. Hetil., 2015, 156(33), 1341–1347.

scholarly journals SUN-342 Effect of Hyperglycemia on Bone Mineral Density and Fracture in Pre-Liver Transplant Recipients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ejigayehu G Abate ◽  
Amanda McKenna
Keyword(s):  
Liver Disease ◽  
Blood Glucose ◽  
Liver Transplant ◽  
Bone Health ◽  
Hemoglobin A1c ◽  
Fasting Glucose ◽  
Fasting Blood Glucose ◽  
Transplant Recipients ◽  
Risk Of Fracture ◽  
Liver Transplant Recipients

Abstract The liver plays an important role in bone and mineral metabolism of patients with end-stage liver disease. These patients are known to have an increased risk of osteoporosis and fractures before liver transplant (LT) with reported fracture incidence of 10-56%. The cause is multifactorial, which includes their underlying liver disease, chronic illness, vitamin D deficiency, and hyponatremia. The impact of hyperglycemia and diabetes mellitus on bone health in liver transplant recipients is not known. Hypothesis: Hyperglycemia increases risk of fracture and osteoporosis in pre- LT patients undergoing LT. Methods: To answer this question, we did a retrospective chart review of consecutive first time, single organ LT recipients at our institution from 2011-2014, who had BMD performed prior to transplantation. We identified 393 patients but included only 209 patients who carried a diagnosis of hyperglycemia or diabetes (type 2 DM, type 1 DM, steroid induced DM and hyperglycemia). BMD was defined based on WHO criteria as Normal, osteopenia and osteoporosis. Hemoglobin A1C was divided into 4 quartiles (A1C ≤5.6%, 5.7-6.4%, 6.5-7.9%, and ≥8%); fasting blood glucose was defined as any venous glucose checked before 9am and labeled as a fasting lab in the chart. Fasting blood glucose was divided into those with BG&lt;100, 101-125, 126-200, &gt;200 mg/dL. We chose labs closest to the transplant date. Pre LT fracture was compared with hemoglobin A1C and BMD as well as fasting glucose. STATA statistical program was used to calculate Fisher T-test. Results: Baseline characteristics of our cohort were as follows. Median BMI was 27.9 (16.2, 45.6). Majority had hepatitis C (33%), NASH 12%, and alcoholic liver disease 23%. Average MELD score was 15 (6-40). Average wait time to transplant was 90 days. 29% of patients had normal BMD, 46% osteopenia and 25% osteoporosis. From the total 209 patients reviewed, 17 had a fracture prior to transplant of which 14/17 had vertebral fractures. The only variable that correlated with risk of fracture was hemoglobin A1C. Higher level of Hemoglobin A1C correlated with the presence of fracture p= 0.04. BMD did not correlate with fracture p= 0.28. There was no association between BMD and Fasting glucose level p=0.55. There was no correlation between fasting glucose and risk of fracture p=0.44. Discussion: This study suggests that a correlation between the presence of pre LT fracture and HgA1C exists. Other factors such as BMD and fasting BG did not correlate with fracture. Those with higher hemoglobin A1C prior to liver transplant might be at risk for fracture compared to those without diabetes or hyperglycemia (A1C &lt;5.7). Benefit of diabetes control for bone health in this population is not known, however we speculate that those with lower A1C, thus better glucose control, have a lower risk of fracture thus aggressive glucose control should be part of the pre transplant care.

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