Association of HbA1c and cardiovascular and renal disease in an adult Mediterranean population
| Autor: | Pedro Ruiz-Esteban, Ana Espejo-Gil, Antonio J Baca-Osorio, Ana María Armas-Padrón, Domingo Hernández, M. Rosa Bernal-Lopez, Jose Mancera-Romero, Armando Torres, Ricardo Gómez-Huelgas, Francisco J. Tinahones |
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| Přispěvatelé: | [Hernandez,D, Ruiz-Esteban,P] Nephrology Department, Hospital Regional Universitario Carlos Haya, Malaga, Spain. [Espejo-Gil,A, Gomez-Huelgas,R] Internal Medicine Department, Hospital Regional Universitario Carlos Haya, Malaga, Spain. [Bernal-Lopez,MR] Biomedical Research Laboratory, Endocrinology Department, Hospital Virgen de la Victoria, Malaga, Spain. [Bernal-Lopez,MR, Tinahones,FJ, Gomez-Huelgas,R] Ciber Fisiopatologia de la Obesidad y Nutricion, Instituto de Salud Carlos III, Madrid, Spain. [Mancera-Romero,J, Baca-Osorio,AJ] Health Care 'Ciudad Jardin', Malaga, Spain. [Tinahones,FJ] Endocrinology Department, Hospital Virgen de la Victoria, Malaga, Spain. [Armas-Padron,AM] Health Care 'La Cuesta',Tenerife, Spain. [Torres,A] Research Unit, Hospital Universitario de Canarias, Tenerife, Spain., This study was funded by grants from the Consejeria de Salud de la Junta de Andalucia (283/06, IMAP study) and FIS PI10/01020 (in part) from the Spanish Ministry of Science and Innovation (MICINN), Instituto de Salud Carlos III, REDINREN RD12/0021/0015, and by grant PI-0499/2009 (in part) from the Consejeria de Salud del Gobierno de Andalucia. |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Nephrology endocrine system diseases Cross-sectional study Estudios transversales España Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings] Diseases::Female Urogenital Diseases and Pregnancy Complications::Female Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency Chronic [Medical Subject Headings] chemistry.chemical_compound Glycated hemoglobin Chronic kidney disease Insuficiencia renal crónica Aged 80 and over Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings] education.field_of_study Diseases::Male Urogenital Diseases::Urologic Diseases::Kidney Diseases::Renal Insufficiency::Renal Insufficiency Chronic [Medical Subject Headings] Mediterranean Region Middle Aged Cardiovascular disease Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings] Cardiovascular Diseases Female Kidney Diseases Hemoglobina A Glucosilada medicine.symptom Enfermedades cardiovasculares Research Article Adult medicine.medical_specialty Adolescent Population Young Adult Internal medicine Diabetes mellitus Diabetes Mellitus medicine Named Groups::Persons::Age Groups::Adult [Medical Subject Headings] Humans Adultos education Diseases::Cardiovascular Diseases [Medical Subject Headings] Aged Glycated Hemoglobin Creatinine business.industry Andalucía medicine.disease Cross-Sectional Studies chemistry Spain Albuminuria Chemicals and Drugs::Amino Acids Peptides and Proteins::Proteins::Blood Proteins::Hemoglobins::Hemoglobin A::Hemoglobin A Glycosylated [Medical Subject Headings] business Biomarkers Kidney disease |
| Zdroj: | BMC Nephrology |
| Popis: | Background Increasing evidence suggests a mechanistic link between the glycemic environment and renal and cardiovascular events, even below the threshold for diabetes. We aimed to assess the association between HbA1c and chronic kidney disease (CKD) and cardiovascular disease (CVD). Methods A cross-sectional study involving a random representative sample of 2270 adults from southern Spain (Malaga) was undertaken. We measured HbA1c, serum creatinine and albuminuria in fasting blood and urine samples. Results Individuals without diabetes in the upper HbA1c tertile had an unfavorable cardiovascular and renal profile and shared certain clinical characteristics with the patients with diabetes. Overall, a higher HbA1c concentration was strongly associated with CKD or CVD after adjustment for traditional risk factors. The patients with known diabetes had a 2-fold higher odds of CKD or CVD. However, when both parameters were introduced in the same model, the HbA1c concentration was only significantly associated with clinical endpoints (OR: 1.4, 95% CI, 1.1-1.6, P = 0.002). An increase in HbA1c of one percentage point was associated with a 30% to 40% increase in the rate of CKD or CVD. This relationship was apparent in persons with and without known diabetes. ROC curves illustrated that a HbA1c of 37 mmol/mol (5.5%) was the optimal value in terms of sensitivity and specificity for predicting endpoints in this population. Conclusion HbA1c levels were associated with a higher prevalence of CKD and CVD cross-sectionally, regardless of diabetes status. These data support the value of HbA1c as a marker of cardiovascular and renal disease in the general population. |
| Databáze: | OpenAIRE |
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