title: Combined effects of glycated hemoglobin A1c and blood pressure on carotid artery atherosclerosis in nondiabetic patients.
abstract: BACKGROUND
  The relationship between HbA(1c), blood pressure, and carotid atherosclerosis in nondiabetic patients is not clear.
  
  
  OBJECTIVE
  HbA(1c) and blood pressure can affect carotid-artery atherosclerosis in nondiabetic patients.
  
  
  METHODS
  This retrospective cross-sectional study included 216 patients without diabetes mellitus. A positive carotid ultrasonographic result was defined as intima-media thickness of the common carotid artery ≥ 0.9 mm, or presence of carotid plaque.
  
  
  RESULTS
  Compared with patients without carotid atherosclerosis, patients with carotid atherosclerosis had significantly higher levels of HbA(1c) and systolic blood pressure (SBP). Higher levels of HbA(1c) and SBP were found to be associated with increased carotid atherosclerosis. Given similar SBP levels, higher HbA(1c) (>5.6%) was also related to increased carotid atherosclerosis. In multiple logistic regression analysis, HbA(1c) (odds ratio: 4.1, P = 0.009) emerged as the only statistically significant modifiable factor that was associated with carotid atherosclerosis, independent of smoking, body mass index, fasting plasma glucose, 2-hour plasma glucose, SBP, diastolic blood pressure, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol.
  
  
  CONCLUSIONS
  Our study shows that a slight increase of HbA(1c) may associate with carotid atherosclerosis in nondiabetic patients. Moreover, the coexistence of an elevated SBP level and a slightly increased HbA(1c) level may have a more significant effect on carotid atherosclerosis.
authors.affiliation: Department of Cardiology, Huashan Hospital, Shanghai Medical School, Fudan University, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhu
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
authors.forename: Haiming
authors.initials: H
authors.lastname: Shi
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: Weiling
authors.initials: W
authors.lastname: Qi
authors.forename: Xinping
authors.initials: X
authors.lastname: Luo
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013599:Systole; D014463:Ultrasonography
chemical_list: D006442:Glycated Hemoglobin