title: Hemoglobin A1c levels and aortic arterial stiffness: the Cardiometabolic Risk in Chinese (CRC) study.
abstract: OBJECTIVE
  The American Diabetes Association (ADA) recently published new clinical guidelines in which hemoglobin A1c (HbA1c) was recommended as a diagnostic test for diabetes. The present study was to investigate the association between HbA1c and cardiovascular risk, and compare the associations with fasting glucose and 2-hour oral glucose tolerance test (2 h OGTT).
  
  
  METHODS
  The study samples are from a community-based health examination survey in central China. Carotid-to-femoral pulse wave velocity (cfPWV) and HbA1c were measured in 5,098 men and women.
  
  
  RESULTS
  After adjustment for age, sex, and BMI, the levels of HbA1c were significantly associated with an increasing trend of cfPWV in a dose-dependent fashion (P for trend <0.0001). The associations remained significant after further adjustment for blood pressure, heart rate, and lipids (P = 0.004), and the difference in cfPWV between the highest and the lowest quintiles of HbA1c was 0.31 m/s. Fasting glucose and 2 h OGTT were not associated with cfPWV in the multivariate analyses. HbA1c showed additive effects with fasting glucose or 2 h OGTT on cfPWV. In addition, age and blood pressure significantly modified the associations between HbA1c and cfPWV (P for interactions <0.0001 for age; and  = 0.019 for blood pressure). The associations were stronger in subjects who were older (≥60 y; P for trend = 0.004) and had higher blood pressure (≥120 [systolic blood pressure]/80 mmHg [diastolic blood pressure]; P for trend = 0.028) than those who were younger and had lower blood pressure (P for trend >0.05).
  
  
  CONCLUSIONS
  HbA1c was related to high cfPWV, independent of conventional cardiovascular risk factors. Senior age and high blood pressure might amplify the adverse effects of HbA1c on cardiovascular risk.
authors.affiliation: Department of Endocrinology, the Central Hospital of Xuzhou, Xuzhou Clinical School of Xuzhou Medical College, Xuzhou, Jiangsu, China. mwlj521@163.com
authors.forename: Jun
authors.initials: J
authors.lastname: Liang
authors.forename: Na
authors.initials: N
authors.lastname: Zhou
authors.forename: Fei
authors.initials: F
authors.lastname: Teng
authors.forename: Caiyan
authors.initials: C
authors.lastname: Zou
authors.forename: Ying
authors.initials: Y
authors.lastname: Xue
authors.forename: Manqing
authors.initials: M
authors.lastname: Yang
authors.forename: Huaidong
authors.initials: H
authors.lastname: Song
authors.forename: Lu
authors.initials: L
authors.lastname: Qi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D002681:China / Q000453:epidemiology; D005215:Fasting / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human