title: High-normal HbA1c is a strong predictor of type 2 diabetes in the general population.
abstract: OBJECTIVE
  Glycosylated hemoglobin (HbA(1c)) recently has been recommended for the diagnosis of diabetes by the American Diabetes Association, but its value in the prediction of type 2 diabetes is poorly understood. In this study we evaluated how high-normal HbA(1c) levels predict type 2 diabetes.
  
  
  METHODS
  We measured HbA(1c) in 919 Caucasian subjects, aged 40-79 years, and recorded new cases of type 2 diabetes in the following 15 years. Diabetes was diagnosed with HbA(1c).
  
  
  RESULTS
  Subjects were stratified according to baseline HbA(1c) (<5.0, 5.00-5.49 [reference], 5.50-5.99, and 6.00-6.49%). Sex- and age-adjusted hazard ratios (95% CI) for type 2 diabetes were 1.11 (0.30-4.41), 1.00, 3.79 (1.79-8.06), and 12.50 (5.51-28.34), respectively. Results did not change after adjusting for several putative confounding factors and were confirmed when models with updated variables were used.
  
  
  CONCLUSIONS
  HbA(1c) is an independent risk factor for type 2 diabetes. Subjects with high-normal levels of HbA(1c) deserve particular attention because they have a strong risk of developing diabetes.
authors.affiliation: Section of Endocrinology and Metabolism, Department of Medicine, University of Verona, Verona,Italy. enzo.bonora@univr.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Bonora
authors.forename: Stefan
authors.initials: S
authors.lastname: Kiechl
authors.forename: Agnes
authors.initials: A
authors.lastname: Mayr
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zoppini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.forename: Riccardo C
authors.initials: RC
authors.lastname: Bonadonna
authors.forename: Johann
authors.initials: J
authors.lastname: Willeit
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin