title: Association of A1C with cardiovascular disease and metabolic syndrome in Asian Indians with normal glucose tolerance.
abstract: OBJECTIVE
  This study examines the association of A1C with cardiovascular disease (CVD) risk factors, coronary artery disease (CAD), and metabolic syndrome in Asian Indians with normal glucose tolerance (NGT).
  
  
  METHODS
  This cross-sectional study recruited subjects from phase III of the Chennai Urban Rural Epidemiology Study (CURES), an epidemiological study in a representative population of Chennai (formerly Madras) in South India, conducted between January 2003 and June 2004. Included were 1,644 subjects with NGT, i.e., fasting plasma glucose <100 mg/dl (5.6 mmol/l) and 2-h postload plasma glucose <140 mg/dl (7.8 mmol/l). A1C was measured using the Biorad Variant machine. Metabolic syndrome was defined based on modified Adult Treatment Panel III guidelines.
  
  
  RESULTS
  The mean +/- SD A1C value in the study cohort was 5.5 +/- 0.4%. A1C showed a significant association with BMI (beta = 0.017, P < 0.001), systolic (beta = 0.002, P = 0.028) and diastolic (beta = 0.202, P = 0.017) blood pressure, waist circumference (beta = 0.007, P < 0.001), serum cholesterol (beta = 0.002, P < 0.001), triglycerides (beta = 0.001, P < 0.001), LDL cholesterol (beta = 0.002, P < 0.001), fasting insulin (beta = 0.009, P < 0.001), and homeostasis model assessment of insulin resistance (beta = 0.047, P < 0.001) after adjusting for age and sex. Regression analysis showed that A1C had a strong association with metabolic syndrome that persisted after adjusting for age and sex (odds ratio [OR] 2.9 [95% CI 2.08-4.00]; P < 0.001). A1C also had a strong association with CAD (2.6 [1.23-5.63]; P = 0.01), but the significance was lost when adjusted for age and sex.
  
  
  CONCLUSIONS
  There is a strong association of A1C with prevalent CVD risk factors in Asian-Indian subjects with NGT.
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India.
authors.forename: James
authors.initials: J
authors.lastname: Dilley
authors.forename: Anbazhagan
authors.initials: A
authors.lastname: Ganesan
authors.forename: Raj
authors.initials: R
authors.lastname: Deepa
authors.forename: Mohan
authors.initials: M
authors.lastname: Deepa
authors.forename: Gopalakrishnan
authors.initials: G
authors.lastname: Sharada
authors.forename: O Dale
authors.initials: OD
authors.lastname: Williams
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D049628:Body Size; D002318:Cardiovascular Diseases / Q000097:blood*; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007194:India; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D012016:Reference Values
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin