title: Glycated hemoglobin as a marker of subclinical atherosclerosis and cardiac remodeling among non-diabetic adults from the general population.
abstract: BACKGROUND
  Elevated glycated hemoglobin (HbA1c) is associated with increased risk of cardiovascular disease (CVD) and mortality but little is known about potential mechanisms underlying the reported associations.
  
  
  METHODS
  We used data from 1798 non-diabetic participants from the population-based cohort Study of Health in Pomerania (SHIP) to investigate cross-sectional and longitudinal associations of HbA1c with subclinical atherosclerosis (common carotid artery intima-media thickness [CCA-IMT]), cardiac structure (left ventricular mass [LVM]), and cardiac function (fractional shortening).
  
  
  RESULTS
  Cross-sectional analyses revealed a positive association between HbA1c and mean CCA-IMT with a 0.02 mm (95% confidence interval: 0.01-0.04) increase in CCA-IMT per 1% increase in HbA1c, and a similar positive trend across HbA1c quartiles (overall p-value <0.01). We also observed a graded association between HbA1c and high CCA-IMT (>75th percentile) with an odds ratio of 1.42 (95% CI: 1.11-1.81) per 1% increase in HbA1c. Longitudinal analyses showed no consistent associations of baseline HbA1c with mean follow-up CCA-IMT. There were no consistent associations of HbA1c with cardiac remodeling in cross-sectional and longitudinal analyses, respectively.
  
  
  CONCLUSIONS
  The association between HbA1c and CCA-IMT in non-diabetic adults may be a crucial link between high-normal HbA1c levels and an increased risk of CVD and mortality.
authors: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany. Electronic address: robin.haring@uni-greifswald.de.
authors: Robin
authors: R
authors: Haring
authors: Institute for Community Medicine, University Medicine Greifswald, Germany.
authors: Sebastian E
authors: SE
authors: Baumeister
authors: Institute for Community Medicine, University Medicine Greifswald, Germany; Institute of Epidemiology, Christian Albrechts University Kiel, Germany.
authors: Wolfgang
authors: W
authors: Lieb
authors: Department of Neurology, University Medicine Greifswald, Germany.
authors: Bettina
authors: B
authors: von Sarnowski
authors: DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany; Institute for Community Medicine, University Medicine Greifswald, Germany.
authors: Henry
authors: H
authors: Völzke
authors: DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany.
authors: Stephan B
authors: SB
authors: Felix
authors: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany.
authors: Matthias
authors: M
authors: Nauck
authors: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Germany.
authors: Henri
authors: H
authors: Wallaschofski
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000032:analysis; D017536:Carotid Artery, Common; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011044:Poland; D012306:Risk; D012307:Risk Factors; D018754:Ventricular Dysfunction / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin
keywords: Atherosclerosis; Cardiac remodeling; Epidemiology; Glycated hemoglobin; Left ventricular mass