title: The Association between HbA1c and Cardiovascular Disease Markers in a Remote Indigenous Australian Community with and without Diagnosed Diabetes.
abstract: OBJECTIVE
  This study investigates the burden of cardiovascular risk markers in people with and without diabetes in a remote Indigenous Australian community, based on their HbA1c concentration.
  
  
  METHODS
  This study included health screening exams of 1187 remote Indigenous residents over 15 years old who represented 70% of the age-eligible community. The participants were stratified by HbA1c into 5 groups using cut-off points recommended by international organisations. The associations of traditional cardiovascular risk markers with HbA1c groups were assessed using logistic and linear regressions and ANOVA models.
  
  
  RESULTS
  Of the 1187 participants, 158 (13%) had a previous diabetes diagnosis, up to 568 (48%) were at high risk (5.7-6.4% (39-46 mmol/mol) HbA1c), and 67 (6%) potential new cases of diabetes (≥6.5% (48 mmol/mol)) were identified. Individuals with higher HbA1c levels were more likely to have albuminuria (OR 3.14, 95% CI 1.26-7.82) and dyslipidaemia (OR 2.37, 95% CI 1.29-4.34) and visited the clinic more often (OR 2.52, 95% CI 1.26-4.99). Almost all traditional CVD risk factors showed a positive association with HbA1c.
  
  
  CONCLUSIONS
  Screening in this remote Indigenous Australian community highlights the high proportion of individuals who are at high risk of diabetes as indicated by HbA1c and who also had an accentuated cardiovascular risk profile.
authors.affiliation: Centre for Chronic Disease, The University of Queensland School of Medicine, Royal Brisbane & Women's Hospital, Health Sciences Building Level 8, Herston, QLD 4029, Australia.
authors.forename: Luke W
authors.initials: LW
authors.lastname: Arnold
authors.affiliation: Centre for Chronic Disease, The University of Queensland School of Medicine, Royal Brisbane & Women's Hospital, Health Sciences Building Level 8, Herston, QLD 4029, Australia.
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Hoy
authors.affiliation: Division of Medicine, Royal Darwin Hospital, Top End Health Network, Northern Territory Government, Tiwi, NT 0810, Australia.
authors.forename: Suresh K
authors.initials: SK
authors.lastname: Sharma
authors.affiliation: Centre for Chronic Disease, The University of Queensland School of Medicine, Royal Brisbane & Women's Hospital, Health Sciences Building Level 8, Herston, QLD 4029, Australia.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000208:ethnology; D001315:Australia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000208:ethnology*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis / Q000208:ethnology*; D050171:Dyslipidemias / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human