Advances in Clinical and Experimental Medicine
2019, vol. 28, nr 5, May, p. 659–664
Publication type: original article
Age is the main determinant of glycated hemoglobin levels in a general Polish population without diabetes: The NATPOL 2011 Study
1 Department of Internal Medicine, Hypertension and Vascular Disease, Medical University of Warsaw, Poland
2 Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kraków, Poland
3 Department of Hypertension and Diabetology, Medical University of Gdańsk, Poland
Background. Measurements of glycated hemoglobin (HbA1c) in non-diabetics can identify subjects who are at increased risk for future cardiovascular (CV) events. There is no consensus agreement whether the addition of HbA1c improves the CV risk prediction.
Objectives. The objective of this study was to assess mean values of HbA1c levels in a representative sample of general, diabetes mellitus (DM)-free Polish population, and its subgroups, and to identify important covariants.
Material and Methods. HbA1c was measured in blood samples collected from 1,868 participants (males/ females (M/F) 901/967, age: range 18–74, mean 44.03 years) of NATPOLL 2011 study without previously and newly diagnosed DM. Univariate and multivariate analyses of HbA1c level in relationship to age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), lipids, creatinine, C-reactive protein (CRP), gender, and smoking status were performed.
Results. Mean HbA1c level was 5.46 ±0.31% in the entire population and significantly higher levels were found in subjects with male gender, hypertension, fasting hyperglycemia, abdominal obesity, and higher BMI values but not in smokers. Univariate analysis revealed numerous significant correlations of HbA1c with the highest values correlation coefficient values for age (r = 0.55), FPG (r = 0.43), WC (r = 0.36), and BMI (r = 0.36). The best, final multivariate model explained 40% of HbA1c variance and the most important covariant was the age, explaining approx. 50% of R2, followed by FPG and BMI.
Conclusion. HbA1c in non-diabetic level is associated with certain CV risk factors, mainly with age. Since known risk factors explain less than a half of HbA1c variance, the inclusion of HbA1c into the assessment may increase the performance of algorithms predicting CV risk.
glycated hemoglobin, age, lipids
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