title: HbA1c is significantly associated with arterial stiffness but not with carotid atherosclerosis in a community-based population without type 2 diabetes: The Dong-gu study.
abstract: OBJECTIVE
  We examined the associations between HbA1c levels and various atherosclerotic vascular parameters among adults without diabetes from the general population.
  
  
  METHODS
  A total of 6500 community-dwelling adults, who were free of type 2 diabetes and ≥50 years of age, were included. High-resolution B-mode ultrasound was used to evaluate carotid artery structure, including intima-media thickness (IMT), plaque, and luminal diameter. Brachial-ankle pulse wave velocity (baPWV), which is a useful indicator of systemic arterial stiffness, was determined using an automatic waveform analysis device.
  
  
  RESULTS
  No significant associations were observed between HbA1c, carotid IMT, plaque, or luminal diameter in a fully adjusted model. However, the odds ratio (95% confidence interval) for high baPWV (defined as the highest quartile) increased by 1.43 (1.19-1.71) per 1% HbA1c increase after adjusting for conventional risk factors in a multivariate logistic regression analysis. In addition, HbA1c was independently associated with baPWV in a multivariate linear regression analysis.
  
  
  CONCLUSIONS
  High-normal HbA1c level was independently associated with arterial stiffness, but not with carotid atherosclerotic parameters, in the general population without diabetes. Our results suggest that the functional atherosclerotic process may already be accelerated according to HbA1c level, even at a level below the diagnostic threshold for diabetes.
authors: Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, South Korea; Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Jeonbuk, South Korea.
authors: Young-Hoon
authors: YH
authors: Lee
authors: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea.
authors: Min-Ho
authors: MH
authors: Shin
authors: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea.
authors: Jin-Su
authors: JS
authors: Choi
authors: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea.
authors: Jung-Ae
authors: JA
authors: Rhee
authors: Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea.
authors: Hae-Sung
authors: HS
authors: Nam
authors: Department of Neurology, Chonbuk National University Medical School-Chonbuk National University Hospital, Jeonju, Jeonbuk, South Korea.
authors: Seul-Ki
authors: SK
authors: Jeong
authors: Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Jeonbuk, South Korea.
authors: Kyeong-Soo
authors: KS
authors: Park
authors: Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea.
authors: So-Yeon
authors: SY
authors: Ryu
authors: Department of Preventive Medicine, Chosun University Medical School, Gwangju, South Korea.
authors: Seong-Woo
authors: SW
authors: Choi
authors: Department of Food & Nutrition, Chosun University College of Natural Sciences, Gwangju, South Korea.
authors: Bok-Hee
authors: BH
authors: Kim
authors: Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, South Korea; Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Jeonbuk, South Korea.
authors: Gyung-Jae
authors: GJ
authors: Oh
authors: Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea; Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea. Electronic address: ujingogo@paran.com.
authors: Sun-Seog
authors: SS
authors: Kweon
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D015994:Incidence; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D058226:Plaque, Atherosclerotic; D015995:Prevalence; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Arterial stiffness; Carotid atherosclerosis; Cross-sectional studies; Glycosylated; Hemoglobin A