title: Hemoglobin A1c and arterial and ventricular stiffness in older adults.
abstract: OBJECTIVE
  Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE) are implicated in this stiffening pathophysiology. We examined the association between HbA(1c), an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes.
  
  
  METHODS
  Baseline HbA(1c) was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c) and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG) with like measures.
  
  
  RESULTS
  HbA(1c) was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both) and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c) was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP), carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM). FG levels were positively associated with systolic, diastolic and PP and LVM.
  
  
  CONCLUSIONS
  In this sample of older adults without diabetes, HbA(1c) was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.
authors.affiliation: National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Zieman
authors.forename: Aruna
authors.initials: A
authors.lastname: Kamineni
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: Joshua
authors.initials: J
authors.lastname: Barzilay
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Kizer
authors.forename: Mary L
authors.initials: ML
authors.lastname: Biggs
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
authors.forename: Michel
authors.initials: M
authors.lastname: Chonchol
authors.forename: John S
authors.initials: JS
authors.lastname: Gottdiener
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D044383:Black People / Q000235:genetics; D001786:Blood Glucose; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D056726:Genetic Association Studies; D006442:Glycated Hemoglobin / Q000235:genetics / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000097:blood / Q000235:genetics; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D059289:Vascular Stiffness
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; C517652:hemoglobin A1c protein, human