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Elizabeth Selvin - One of the best experts on this subject based on the ideXlab platform.

  • Glycated Hemoglobin and cancer incidence and mortality in the atherosclerosis in communities aric study 1990 2006
    International Journal of Cancer, 2012
    Co-Authors: Corinne E Joshu, Frederick L Brancati, Josef Coresh, Anna E Prizment, Paul J Dluzniewski, Andy Menke, Aaron R Folsom, Elizabeth A Platz, Elizabeth Selvin
    Abstract:

    Diabetes is a risk factor for many cancers; chronic hyperglycemia is hypothesized to be, in part, explanatory. We evaluated the association between Glycated Hemoglobin, a time-integrated glycemia measure, and cancer incidence and mortality in non-diabetic and diabetic men and women. We conducted a prospective study of 12,792 cancer-free participants attending the second visit (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) Study. We measured Glycated Hemoglobin in whole-blood samples using HPLC. Incident cancers were ascertained from registries and hospital records through 2006. We estimated multivariable-adjusted hazard ratios (HR) of cancer incidence and mortality for non-diabetic participants with values ≥5.7% (elevated), non-diabetic participants with <5.0% (low), and diabetic participants all compared with non-diabetic participants with 5.0–5.6% (normal). We ascertained 2,349 incident cancer cases and 887 cancer deaths. Compared with non-diabetic women with normal Glycated Hemoglobin, non-diabetic women with elevated values had an increased risk of cancer incidence (HR:1.24; 95% CI:1.07,1.44) and mortality (HR:1.58; 95% CI:1.23,2.05) as did diabetic women (incidence, HR:1.30; 95% CI:1.06,1.60, mortality, HR:1.96; 95% CI:1.40,2.76). Non-diabetic women with low values also had increased risk. Diabetic women with good glycemic control (<7.0%) had a lower cancer risk than those with higher values. Glycated Hemoglobin in non-diabetic and diabetic men, and diabetes were not statistically significantly associated with total cancer risk. Our findings support the hypothesis that chronic hyperglycemia, even in the non-diabetic range, increases cancer risk in women. Maintaining normal Glycated Hemoglobin overall, and good glycemic control among diabetic adults, may reduce the burden of cancer, especially in women.

  • Glycated Hemoglobin and cancer incidence and mortality in the Atherosclerosis in Communities (ARIC) Study, 1990-2006.
    International Journal of Cancer, 2012
    Co-Authors: Corinne E Joshu, Frederick L Brancati, Josef Coresh, Anna E Prizment, Paul J Dluzniewski, Andy Menke, Aaron R Folsom, Elizabeth A Platz, Elizabeth Selvin
    Abstract:

    Diabetes is a risk factor for many cancers; chronic hyperglycemia is hypothesized to be, in part, explanatory. We evaluated the association between Glycated Hemoglobin, a time-integrated glycemia measure, and cancer incidence and mortality in non-diabetic and diabetic men and women. We conducted a prospective study of 12,792 cancer-free participants attending the second visit (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) Study. We measured Glycated Hemoglobin in whole-blood samples using HPLC. Incident cancers were ascertained from registries and hospital records through 2006. We estimated multivariable-adjusted hazard ratios (HR) of cancer incidence and mortality for non-diabetic participants with values ≥5.7% (elevated), non-diabetic participants with

  • Glycated Hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes
    Diabetes, 2011
    Co-Authors: Elizabeth Selvin, Michael W Steffes, Yang Ning, Lori D Bash, Ronald Klein, Tien Yin Wong, Brad C Astor, Richey A Sharrett
    Abstract:

    OBJECTIVE Glycated Hemoglobin was recently recommended for use as a diagnostic test for diabetes. We examined the association between 2010 American Diabetes Association diagnostic cut points for Glycated Hemoglobin and microvascular outcomes (chronic kidney disease, end-stage renal disease [ESRD], and retinopathy) and formally tested for the presence of risk thresholds in the relationships of Glycated Hemoglobin with these outcomes. RESEARCH DESIGN AND METHODS Prospective cohort and cross-sectional analyses of 11,357 participants (773 with a history of diagnosed diabetes) from the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS During a median of 14 years of follow-up of individuals without diagnosed diabetes at baseline, clinical categories of Glycated Hemoglobin were associated with risk of chronic kidney disease, with adjusted hazard ratios (HRs) of 1.12 (0.94–1.34) and 1.39 (1.04–1.85) for Glycated Hemoglobin 5.7–6.4% and ≥6.5%, respectively, as compared with <5.7% ( P trend = 0.002). The corresponding HRs for ESRD were 1.51 (0.82–2.76) and 1.98 (0.83–4.73), respectively ( P trend = 0.047). In the absence of diagnosed diabetes, Glycated Hemoglobin was cross sectionally associated with the presence of moderate/severe retinopathy, with adjusted odds ratios of 1.42 (0.69–2.92) and 2.91 (1.19–7.11) for Glycated Hemoglobin 5.7–<6.5% and ≥6.5%, respectively, compared with <5.7% ( P trend = 0.011). Risk associations were stronger among individuals with a history of diabetes. We did not observe significant thresholds in the associations of Glycated Hemoglobin with kidney disease risk or retinopathy. CONCLUSIONS These data from a community-based, biracial population support the use of new 2010 American Diabetes Association Glycated Hemoglobin cut points for the diagnosis of diabetes.

  • Glycated Hemoglobin and the Risk of Kidney Disease and Retinopathy In Adults with and Without Diabetes
    Diabetes, 2010
    Co-Authors: Elizabeth Selvin, Frederick L Brancati, Michael W Steffes, Yang Ning, Lori D Bash, Ronald Klein, Tien Yin Wong, Brad C Astor, A. Richey Sharrett, Josef Coresh
    Abstract:

    OBJECTIVE—Glycated Hemoglobin was recently recommended for use as a diagnostic test for diabetes. We examined the association between 2010 American Diabetes Association diagnostic cut points for Glycated Hemoglobin and microvascular outcomes (chronic kidney disease, end-stage renal disease [ESRD], and retinopathy) and formally tested for the presence of risk thresholds in the relationships of Glycated Hemoglobin with these outcomes. RESEARCH DESIGN AND METHODS—Prospective cohort and cross-sectional analyses of 11,357 participants (773 with a history of diagnosed diabetes) from the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS—During a median of 14 years of follow-up of individuals without diagnosed diabetes at baseline, clinical categories of Glycated Hemoglobin were associated with risk of chronic kidney disease, with adjusted hazard ratios (HRs) of 1.12 (0.94 –1.34) and 1.39 (1.04 –1.85) for Glycated Hemoglobin 5.7– 6.4% and 6.5%, respectively, as compared with 5.7% (P trend 0.002). The corresponding HRs for ESRD were 1.51 (0.82–2.76) and 1.98 (0.83– 4.73), respectively (P trend 0.047). In the absence of diagnosed diabetes, Glycated Hemoglobin was cross sectionally associated with the presence of moderate/severe retinopathy, with adjusted odds ratios of 1.42 (0.69 –2.92) and 2.91 (1.19 –7.11) for Glycated Hemoglobin 5.7–6.5% and 6.5%, respectively, compared with 5.7% (P trend 0.011). Risk associations were stronger among individuals with a history of diabetes. We did not observe significant thresholds in the associations of Glycated Hemoglobin with kidney disease risk or retinopathy. CONCLUSIONS—These data from a community-based, biracial population support the use of new 2010 American Diabetes Association Glycated Hemoglobin cut points for the diagnosis of diabetes. Diabetes 60:298–305, 2011

  • Glycated Hemoglobin diabetes and cardiovascular risk in nondiabetic adults
    The New England Journal of Medicine, 2010
    Co-Authors: Elizabeth Selvin, Lynne Wagenknecht, James Pankow, Kunihiro Matsushita, Michael W Steffes, Josef Coresh, Frederick L Brancati
    Abstract:

    Methods We compared the prognostic value of Glycated Hemoglobin and fasting glucose for identifying adults at risk for diabetes or cardiovascular disease. We measured Glycated Hemoglobin in whole-blood samples from 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease and who attended the second visit (occurring in the 1990–1992 period) of the Atherosclerosis Risk in Communities (ARIC) study. Results The Glycated Hemoglobin value at baseline was associated with newly diagnosed diabetes and cardiovascular outcomes. For Glycated Hemoglobin values of less than 5.0%, 5.0 to less than 5.5%, 5.5 to less than 6.0%, 6.0 to less than 6.5%, and 6.5% or greater, the multivariable-adjusted hazard ratios (with 95% confidence intervals) for diagnosed diabetes were 0.52 (0.40 to 0.69), 1.00 (reference), 1.86 (1.67 to 2.08), 4.48 (3.92 to 5.13), and 16.47 (14.22 to 19.08), respectively. For coronary heart disease, the hazard ratios were 0.96 (0.74 to 1.24), 1.00 (reference), 1.23 (1.07 to 1.41), 1.78 (1.48 to 2.15), and 1.95 (1.53 to 2.48), respectively. The hazard ratios for stroke were similar. In contrast, Glycated Hemoglobin and death from any cause were found to have a J-shaped association curve. All these associations remained significant after adjustment for the baseline fasting glucose level. The association between the fasting glucose levels and the risk of cardiovascular disease or death from any cause was not significant in models with adjustment for all covariates as well as Glycated Hemoglobin. For coronary heart disease, measures of risk discrimination showed significant improvement when Glycated Hemoglobin was added to models including fasting glucose. Conclusions In this community-based population of nondiabetic adults, Glycated Hemoglobin was similarly associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause as compared with fasting glucose. These data add to the evidence supporting the use of Glycated Hemoglobin as a diagnostic test for diabetes.

Frederick L Brancati - One of the best experts on this subject based on the ideXlab platform.

  • Glycated Hemoglobin and cancer incidence and mortality in the atherosclerosis in communities aric study 1990 2006
    International Journal of Cancer, 2012
    Co-Authors: Corinne E Joshu, Frederick L Brancati, Josef Coresh, Anna E Prizment, Paul J Dluzniewski, Andy Menke, Aaron R Folsom, Elizabeth A Platz, Elizabeth Selvin
    Abstract:

    Diabetes is a risk factor for many cancers; chronic hyperglycemia is hypothesized to be, in part, explanatory. We evaluated the association between Glycated Hemoglobin, a time-integrated glycemia measure, and cancer incidence and mortality in non-diabetic and diabetic men and women. We conducted a prospective study of 12,792 cancer-free participants attending the second visit (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) Study. We measured Glycated Hemoglobin in whole-blood samples using HPLC. Incident cancers were ascertained from registries and hospital records through 2006. We estimated multivariable-adjusted hazard ratios (HR) of cancer incidence and mortality for non-diabetic participants with values ≥5.7% (elevated), non-diabetic participants with <5.0% (low), and diabetic participants all compared with non-diabetic participants with 5.0–5.6% (normal). We ascertained 2,349 incident cancer cases and 887 cancer deaths. Compared with non-diabetic women with normal Glycated Hemoglobin, non-diabetic women with elevated values had an increased risk of cancer incidence (HR:1.24; 95% CI:1.07,1.44) and mortality (HR:1.58; 95% CI:1.23,2.05) as did diabetic women (incidence, HR:1.30; 95% CI:1.06,1.60, mortality, HR:1.96; 95% CI:1.40,2.76). Non-diabetic women with low values also had increased risk. Diabetic women with good glycemic control (<7.0%) had a lower cancer risk than those with higher values. Glycated Hemoglobin in non-diabetic and diabetic men, and diabetes were not statistically significantly associated with total cancer risk. Our findings support the hypothesis that chronic hyperglycemia, even in the non-diabetic range, increases cancer risk in women. Maintaining normal Glycated Hemoglobin overall, and good glycemic control among diabetic adults, may reduce the burden of cancer, especially in women.

  • Glycated Hemoglobin and cancer incidence and mortality in the Atherosclerosis in Communities (ARIC) Study, 1990-2006.
    International Journal of Cancer, 2012
    Co-Authors: Corinne E Joshu, Frederick L Brancati, Josef Coresh, Anna E Prizment, Paul J Dluzniewski, Andy Menke, Aaron R Folsom, Elizabeth A Platz, Elizabeth Selvin
    Abstract:

    Diabetes is a risk factor for many cancers; chronic hyperglycemia is hypothesized to be, in part, explanatory. We evaluated the association between Glycated Hemoglobin, a time-integrated glycemia measure, and cancer incidence and mortality in non-diabetic and diabetic men and women. We conducted a prospective study of 12,792 cancer-free participants attending the second visit (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) Study. We measured Glycated Hemoglobin in whole-blood samples using HPLC. Incident cancers were ascertained from registries and hospital records through 2006. We estimated multivariable-adjusted hazard ratios (HR) of cancer incidence and mortality for non-diabetic participants with values ≥5.7% (elevated), non-diabetic participants with

  • Glycated Hemoglobin and the Risk of Kidney Disease and Retinopathy In Adults with and Without Diabetes
    Diabetes, 2010
    Co-Authors: Elizabeth Selvin, Frederick L Brancati, Michael W Steffes, Yang Ning, Lori D Bash, Ronald Klein, Tien Yin Wong, Brad C Astor, A. Richey Sharrett, Josef Coresh
    Abstract:

    OBJECTIVE—Glycated Hemoglobin was recently recommended for use as a diagnostic test for diabetes. We examined the association between 2010 American Diabetes Association diagnostic cut points for Glycated Hemoglobin and microvascular outcomes (chronic kidney disease, end-stage renal disease [ESRD], and retinopathy) and formally tested for the presence of risk thresholds in the relationships of Glycated Hemoglobin with these outcomes. RESEARCH DESIGN AND METHODS—Prospective cohort and cross-sectional analyses of 11,357 participants (773 with a history of diagnosed diabetes) from the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS—During a median of 14 years of follow-up of individuals without diagnosed diabetes at baseline, clinical categories of Glycated Hemoglobin were associated with risk of chronic kidney disease, with adjusted hazard ratios (HRs) of 1.12 (0.94 –1.34) and 1.39 (1.04 –1.85) for Glycated Hemoglobin 5.7– 6.4% and 6.5%, respectively, as compared with 5.7% (P trend 0.002). The corresponding HRs for ESRD were 1.51 (0.82–2.76) and 1.98 (0.83– 4.73), respectively (P trend 0.047). In the absence of diagnosed diabetes, Glycated Hemoglobin was cross sectionally associated with the presence of moderate/severe retinopathy, with adjusted odds ratios of 1.42 (0.69 –2.92) and 2.91 (1.19 –7.11) for Glycated Hemoglobin 5.7–6.5% and 6.5%, respectively, compared with 5.7% (P trend 0.011). Risk associations were stronger among individuals with a history of diabetes. We did not observe significant thresholds in the associations of Glycated Hemoglobin with kidney disease risk or retinopathy. CONCLUSIONS—These data from a community-based, biracial population support the use of new 2010 American Diabetes Association Glycated Hemoglobin cut points for the diagnosis of diabetes. Diabetes 60:298–305, 2011

  • Glycated Hemoglobin diabetes and cardiovascular risk in nondiabetic adults
    The New England Journal of Medicine, 2010
    Co-Authors: Elizabeth Selvin, Lynne Wagenknecht, James Pankow, Kunihiro Matsushita, Michael W Steffes, Josef Coresh, Frederick L Brancati
    Abstract:

    Methods We compared the prognostic value of Glycated Hemoglobin and fasting glucose for identifying adults at risk for diabetes or cardiovascular disease. We measured Glycated Hemoglobin in whole-blood samples from 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease and who attended the second visit (occurring in the 1990–1992 period) of the Atherosclerosis Risk in Communities (ARIC) study. Results The Glycated Hemoglobin value at baseline was associated with newly diagnosed diabetes and cardiovascular outcomes. For Glycated Hemoglobin values of less than 5.0%, 5.0 to less than 5.5%, 5.5 to less than 6.0%, 6.0 to less than 6.5%, and 6.5% or greater, the multivariable-adjusted hazard ratios (with 95% confidence intervals) for diagnosed diabetes were 0.52 (0.40 to 0.69), 1.00 (reference), 1.86 (1.67 to 2.08), 4.48 (3.92 to 5.13), and 16.47 (14.22 to 19.08), respectively. For coronary heart disease, the hazard ratios were 0.96 (0.74 to 1.24), 1.00 (reference), 1.23 (1.07 to 1.41), 1.78 (1.48 to 2.15), and 1.95 (1.53 to 2.48), respectively. The hazard ratios for stroke were similar. In contrast, Glycated Hemoglobin and death from any cause were found to have a J-shaped association curve. All these associations remained significant after adjustment for the baseline fasting glucose level. The association between the fasting glucose levels and the risk of cardiovascular disease or death from any cause was not significant in models with adjustment for all covariates as well as Glycated Hemoglobin. For coronary heart disease, measures of risk discrimination showed significant improvement when Glycated Hemoglobin was added to models including fasting glucose. Conclusions In this community-based population of nondiabetic adults, Glycated Hemoglobin was similarly associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause as compared with fasting glucose. These data add to the evidence supporting the use of Glycated Hemoglobin as a diagnostic test for diabetes.

  • Glycated Hemoglobin, Diabetes, and Cardiovascular Risk in Nondiabetic Adults
    New England Journal of Medicine, 2010
    Co-Authors: Elizabeth Selvin, Lynne Wagenknecht, James Pankow, Kunihiro Matsushita, Michael W Steffes, Hong Zhu, Josef Coresh, Frederick L Brancati
    Abstract:

    Fasting glucose is the standard measure used to diagnose diabetes in the United States. Recently, Glycated Hemoglobin was also recommended for this purpose.

Stuart A Chalew - One of the best experts on this subject based on the ideXlab platform.

  • two dimensional analysis of Glycated Hemoglobin heterogeneity in pediatric type 1 diabetes patients
    Analytical Biochemistry, 2013
    Co-Authors: James M Hempe, Amanda M Mcgehee, Stuart A Chalew
    Abstract:

    Interindividual and ethnic variation in Glycated Hemoglobin levels, unrelated to blood glucose variation, complicates the clinical use of Glycated Hemoglobin assays for the diagnosis and management of diabetes. Assessing the types and amounts of Glycated Hemoglobins present in erythrocytes could provide insight into the mechanism. Blood samples and self-monitored mean blood glucose (MBG) levels were obtained from 85 pediatric type 1 diabetes patients. Glycated Hemoglobin levels were measured using three primary assays (boronate-affinity chromatography, capillary isoelectric focusing (CIEF), and standardized DCA2000+ immunoassay) and a two-dimensional (2D) analytical system consisting of boronate-affinity chromatography followed by CIEF. The 2D system separated Hemoglobin into five subfractions, four of which contained Glycated Hemoglobins. Glycated Hemoglobin measurements were compared in patients with low, moderate, or high Hemoglobin glycation index (HGI), a measure of Glycated Hemoglobin controlled for blood glucose variation. MBG was not significantly different between HGI groups. Glycated Hemoglobin levels measured by all three primary assays and in all four Glycated 2D subfractions were significantly different between HGI groups and highest in high HGI patients. These results show that interindividual variation in Glycated Hemoglobin levels was evident in diabetes patients with similar blood glucose levels regardless of which Glycated Hemoglobins were measured.

Shangfeng Tsai - One of the best experts on this subject based on the ideXlab platform.

Josef Coresh - One of the best experts on this subject based on the ideXlab platform.

  • Glycated Hemoglobin and cancer incidence and mortality in the atherosclerosis in communities aric study 1990 2006
    International Journal of Cancer, 2012
    Co-Authors: Corinne E Joshu, Frederick L Brancati, Josef Coresh, Anna E Prizment, Paul J Dluzniewski, Andy Menke, Aaron R Folsom, Elizabeth A Platz, Elizabeth Selvin
    Abstract:

    Diabetes is a risk factor for many cancers; chronic hyperglycemia is hypothesized to be, in part, explanatory. We evaluated the association between Glycated Hemoglobin, a time-integrated glycemia measure, and cancer incidence and mortality in non-diabetic and diabetic men and women. We conducted a prospective study of 12,792 cancer-free participants attending the second visit (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) Study. We measured Glycated Hemoglobin in whole-blood samples using HPLC. Incident cancers were ascertained from registries and hospital records through 2006. We estimated multivariable-adjusted hazard ratios (HR) of cancer incidence and mortality for non-diabetic participants with values ≥5.7% (elevated), non-diabetic participants with <5.0% (low), and diabetic participants all compared with non-diabetic participants with 5.0–5.6% (normal). We ascertained 2,349 incident cancer cases and 887 cancer deaths. Compared with non-diabetic women with normal Glycated Hemoglobin, non-diabetic women with elevated values had an increased risk of cancer incidence (HR:1.24; 95% CI:1.07,1.44) and mortality (HR:1.58; 95% CI:1.23,2.05) as did diabetic women (incidence, HR:1.30; 95% CI:1.06,1.60, mortality, HR:1.96; 95% CI:1.40,2.76). Non-diabetic women with low values also had increased risk. Diabetic women with good glycemic control (<7.0%) had a lower cancer risk than those with higher values. Glycated Hemoglobin in non-diabetic and diabetic men, and diabetes were not statistically significantly associated with total cancer risk. Our findings support the hypothesis that chronic hyperglycemia, even in the non-diabetic range, increases cancer risk in women. Maintaining normal Glycated Hemoglobin overall, and good glycemic control among diabetic adults, may reduce the burden of cancer, especially in women.

  • Glycated Hemoglobin and cancer incidence and mortality in the Atherosclerosis in Communities (ARIC) Study, 1990-2006.
    International Journal of Cancer, 2012
    Co-Authors: Corinne E Joshu, Frederick L Brancati, Josef Coresh, Anna E Prizment, Paul J Dluzniewski, Andy Menke, Aaron R Folsom, Elizabeth A Platz, Elizabeth Selvin
    Abstract:

    Diabetes is a risk factor for many cancers; chronic hyperglycemia is hypothesized to be, in part, explanatory. We evaluated the association between Glycated Hemoglobin, a time-integrated glycemia measure, and cancer incidence and mortality in non-diabetic and diabetic men and women. We conducted a prospective study of 12,792 cancer-free participants attending the second visit (1990–1992) of the Atherosclerosis Risk in Communities (ARIC) Study. We measured Glycated Hemoglobin in whole-blood samples using HPLC. Incident cancers were ascertained from registries and hospital records through 2006. We estimated multivariable-adjusted hazard ratios (HR) of cancer incidence and mortality for non-diabetic participants with values ≥5.7% (elevated), non-diabetic participants with

  • Glycated Hemoglobin and the Risk of Kidney Disease and Retinopathy In Adults with and Without Diabetes
    Diabetes, 2010
    Co-Authors: Elizabeth Selvin, Frederick L Brancati, Michael W Steffes, Yang Ning, Lori D Bash, Ronald Klein, Tien Yin Wong, Brad C Astor, A. Richey Sharrett, Josef Coresh
    Abstract:

    OBJECTIVE—Glycated Hemoglobin was recently recommended for use as a diagnostic test for diabetes. We examined the association between 2010 American Diabetes Association diagnostic cut points for Glycated Hemoglobin and microvascular outcomes (chronic kidney disease, end-stage renal disease [ESRD], and retinopathy) and formally tested for the presence of risk thresholds in the relationships of Glycated Hemoglobin with these outcomes. RESEARCH DESIGN AND METHODS—Prospective cohort and cross-sectional analyses of 11,357 participants (773 with a history of diagnosed diabetes) from the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS—During a median of 14 years of follow-up of individuals without diagnosed diabetes at baseline, clinical categories of Glycated Hemoglobin were associated with risk of chronic kidney disease, with adjusted hazard ratios (HRs) of 1.12 (0.94 –1.34) and 1.39 (1.04 –1.85) for Glycated Hemoglobin 5.7– 6.4% and 6.5%, respectively, as compared with 5.7% (P trend 0.002). The corresponding HRs for ESRD were 1.51 (0.82–2.76) and 1.98 (0.83– 4.73), respectively (P trend 0.047). In the absence of diagnosed diabetes, Glycated Hemoglobin was cross sectionally associated with the presence of moderate/severe retinopathy, with adjusted odds ratios of 1.42 (0.69 –2.92) and 2.91 (1.19 –7.11) for Glycated Hemoglobin 5.7–6.5% and 6.5%, respectively, compared with 5.7% (P trend 0.011). Risk associations were stronger among individuals with a history of diabetes. We did not observe significant thresholds in the associations of Glycated Hemoglobin with kidney disease risk or retinopathy. CONCLUSIONS—These data from a community-based, biracial population support the use of new 2010 American Diabetes Association Glycated Hemoglobin cut points for the diagnosis of diabetes. Diabetes 60:298–305, 2011

  • Glycated Hemoglobin diabetes and cardiovascular risk in nondiabetic adults
    The New England Journal of Medicine, 2010
    Co-Authors: Elizabeth Selvin, Lynne Wagenknecht, James Pankow, Kunihiro Matsushita, Michael W Steffes, Josef Coresh, Frederick L Brancati
    Abstract:

    Methods We compared the prognostic value of Glycated Hemoglobin and fasting glucose for identifying adults at risk for diabetes or cardiovascular disease. We measured Glycated Hemoglobin in whole-blood samples from 11,092 black or white adults who did not have a history of diabetes or cardiovascular disease and who attended the second visit (occurring in the 1990–1992 period) of the Atherosclerosis Risk in Communities (ARIC) study. Results The Glycated Hemoglobin value at baseline was associated with newly diagnosed diabetes and cardiovascular outcomes. For Glycated Hemoglobin values of less than 5.0%, 5.0 to less than 5.5%, 5.5 to less than 6.0%, 6.0 to less than 6.5%, and 6.5% or greater, the multivariable-adjusted hazard ratios (with 95% confidence intervals) for diagnosed diabetes were 0.52 (0.40 to 0.69), 1.00 (reference), 1.86 (1.67 to 2.08), 4.48 (3.92 to 5.13), and 16.47 (14.22 to 19.08), respectively. For coronary heart disease, the hazard ratios were 0.96 (0.74 to 1.24), 1.00 (reference), 1.23 (1.07 to 1.41), 1.78 (1.48 to 2.15), and 1.95 (1.53 to 2.48), respectively. The hazard ratios for stroke were similar. In contrast, Glycated Hemoglobin and death from any cause were found to have a J-shaped association curve. All these associations remained significant after adjustment for the baseline fasting glucose level. The association between the fasting glucose levels and the risk of cardiovascular disease or death from any cause was not significant in models with adjustment for all covariates as well as Glycated Hemoglobin. For coronary heart disease, measures of risk discrimination showed significant improvement when Glycated Hemoglobin was added to models including fasting glucose. Conclusions In this community-based population of nondiabetic adults, Glycated Hemoglobin was similarly associated with a risk of diabetes and more strongly associated with risks of cardiovascular disease and death from any cause as compared with fasting glucose. These data add to the evidence supporting the use of Glycated Hemoglobin as a diagnostic test for diabetes.

  • Glycated Hemoglobin, Diabetes, and Cardiovascular Risk in Nondiabetic Adults
    New England Journal of Medicine, 2010
    Co-Authors: Elizabeth Selvin, Lynne Wagenknecht, James Pankow, Kunihiro Matsushita, Michael W Steffes, Hong Zhu, Josef Coresh, Frederick L Brancati
    Abstract:

    Fasting glucose is the standard measure used to diagnose diabetes in the United States. Recently, Glycated Hemoglobin was also recommended for this purpose.