HbA1c in relation to incident diabetes and diabetes-related complications in non-diabetic adults at baseline

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dc.contributor.author Metcalf, Patricia en
dc.contributor.author Kyle, C en
dc.contributor.author Kenealy, Timothy en
dc.contributor.author Jackson, Rodney en
dc.date.accessioned 2017-08-28T23:33:15Z en
dc.date.issued 2017-05 en
dc.identifier.citation Journal of Diabetes and its Complications 31(5):814-823 May 2017 en
dc.identifier.issn 1056-8727 en
dc.identifier.uri http://hdl.handle.net/2292/35397 en
dc.description.abstract We compared the utility of glycated hemoglobin (HbA1c) and oral glucose tolerance (oGTT) in non-diabetic patients for identifying incident diabetes; all-cause mortality; cardiovascular disease (CVD) mortality; CVD, coronary heart disease (CHD), and ischemic stroke events; and diabetes microvascular complications.Data from a New Zealand community setting were prospectively linked to hospitalization, mortality, pharmaceutical and laboratory test results data. After applying exclusion criteria (prior laboratory diagnosis or history of drug treatment for diabetes or hospitalization for diabetes or CVD event), there were 31,148 adults who had an HbA1c and 2-h 75g oGTT. HbA1c was measured by ion-exchange high-performance liquid chromatography, and glucose using a commercial enzymatic method. We compared glycemic measures and outcomes using multivariable Cox proportional hazards regression.The median follow-up time was 4years (range 0 to 13). The mean age was 57·6years and 53·0% were male. After adjusting for other glycemic measures (fasting glucose, 2-h glucose and/or HbA1c where relevant) in addition to age, sex, ethnicity and smoking habit, the hazard ratios for incident diabetes and diabetes complications of retinopathy and nephropathy were highest for 2-h glucose levels, followed by HbA1c and lastly by fasting glucose. However, all-cause mortality and CHD were significantly associated with HbA1c concentrations only, and ischemic stroke and CVD events with 2-h glucose only. Circulatory complications showed a stronger association with HbA1c.Apart from neuropathy, HbA1c showed stronger associations with outcomes compared to fasting glucose and provides a convenient alternative to an oGTT. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.publisher Elsevier BV en
dc.relation.ispartofseries Journal of Diabetes and its Complications en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title HbA1c in relation to incident diabetes and diabetes-related complications in non-diabetic adults at baseline en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.jdiacomp.2017.02.007 en
pubs.issue 5 en
pubs.begin-page 814 en
pubs.volume 31 en
dc.rights.holder Copyright: Elsevier BV en
dc.identifier.pmid 28319002 en
pubs.end-page 823 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 619743 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Epidemiology & Biostatistics en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
pubs.org-id Science en
pubs.org-id Statistics en
dc.identifier.eissn 1873-460X en
pubs.record-created-at-source-date 2017-08-29 en
pubs.dimensions-id 28319002 en

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