Glycated Hemoglobin and Subclinical Atherosclerosis in People Without Diabetes

The metabolic injury caused by protein glycation, monitored as the level of glycated hemoglobin (HbA1c), is not represented in most risk scores (i.e., Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease risk scale). The purpose of this study was to assess the association be...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2021-06, Vol.77 (22), p.2777-2791
Main Authors: Rossello, Xavier, Raposeiras-Roubin, Sergio, Oliva, Belén, Sánchez-Cabo, Fátima, García-Ruíz, José M, Caimari, Francisca, Mendiguren, José M, Lara-Pezzi, Enrique, Bueno, Héctor, Fernández-Friera, Leticia, Fernández-Ortiz, Antonio, Sanz, Javier, Ibanez, Borja, Fuster, Valentin
Format: Article
Language:English
Subjects:
Adult
Arteries - diagnostic imaging
Asymptomatic Diseases
Atherosclerosis - blood
Atherosclerosis - diagnostic imaging
Blood Glucose
Cardiac Imaging Techniques
Cardiometabolic Risk Factors
Female
Glycated Hemoglobin A - metabolism
Humans
Male
Middle Aged
Plaque, Atherosclerotic - blood
Plaque, Atherosclerotic - diagnostic imaging
Prospective Studies
Risk Assessment
Tomography, X-Ray Computed
Ultrasonography
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Summary:The metabolic injury caused by protein glycation, monitored as the level of glycated hemoglobin (HbA1c), is not represented in most risk scores (i.e., Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease risk scale). The purpose of this study was to assess the association between HbA1c and the extent of subclinical atherosclerosis (SA) and to better identify individuals at higher risk of extensive SA using HbA1c on top of key cardiovascular risk factors (CVRFs). A cohort of 3,973 middle-aged individuals from the PESA (Progression of Early Subclinical Atherosclerosis) study, with no history of cardiovascular disease and with HbA1c in the nondiabetic range, were assessed for the presence and extent of SA by 2-dimensional vascular ultrasound and noncontrast cardiac computed tomography. After adjusting for established CVRFs, HbA1c showed an association with the multiterritorial extent of SA (odds ratio: 1.05, 1.27, 1.27, 1.36, 1.80, 1.87, and 2.47 for HbA1c 4.9% to 5.0%, 5.1% to 5.2%, 5.3% to 5.4%, 5.5% to 5.6%, 5.7% to 5.8%, 5.9% to 6.0%, and 6.1% to 6.4%, respectively; reference HbA1c ≤4.8%; p 
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2021.03.335