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Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans.
J Diabetes. 2016 Sep; 8(5):657-66.JD

Abstract

BACKGROUND

The aim of the present study was to compare the association between cardiovascular diseases (CVD) and prediabetes defined by either fasting plasma glucose (FPG), HbA1c, or their combination in a Korean population.

METHODS

In all, 76 434 South Koreans who voluntarily underwent a general health examination in the Health Screening & Promotion Center (Asan Medical Center) were analyzed after excluding patients with a previous history of CVD. Cardiovascular events and death due to CVD during a median follow-up period of 3.1 years (interquartile range 1.9-4.3 years) were identified from the Nationwide Health Insurance Claims Database and death certificates using ICD-10 codes.

RESULTS

Age- and sex-adjusted hazard ratios (HRs) for overall CVD events were significantly greater for subjects with prediabetes defined by FPG only (HR 1.19; 95% confidence interval [CI] 1.08-1.31), HbA1c only (HR 1.28; 95% CI 1.16-1.42), and combined criteria (HR 1.20; 95% CI 1.09-1.32) compared with the normoglycemic group. After adjusting for multiple conventional risk factors (e.g. hypertension, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, smoking status, family history of CVD, and BMI), the HRs for overall CVD were significantly increased only for participants with prediabetes defined by HbA1c. Age- and sex-adjusted HRs for major ischemic heart disease events were significantly increased for subjects with prediabetes defined either by HbA1c or combined criteria. Similarly, age- and sex-adjusted HRs for percutaneous coronary intervention were significantly higher for subjects with prediabetes defined by HbA1c only. For diabetes, the multivariate-adjusted HRs for all outcomes were significantly increased by all three criteria.

CONCLUSIONS

Adding an HbA1c criterion when defining prediabetes in Koreans can help identify individuals with an increased risk of CVD.

Authors+Show Affiliations

Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.Division of Cardiology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.Division of Cardiology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26355268

Citation

Kim, Hong-Kyu, et al. "Association of Prediabetes, Defined By Fasting Glucose, HbA1c Only, or Combined Criteria, With the Risk of Cardiovascular Disease in Koreans." Journal of Diabetes, vol. 8, no. 5, 2016, pp. 657-66.
Kim HK, Lee JB, Kim SH, et al. Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans. J Diabetes. 2016;8(5):657-66.
Kim, H. K., Lee, J. B., Kim, S. H., Jo, M. W., Kim, E. H., Hwang, J. Y., Bae, S. J., Jung, C. H., Lee, W. J., Park, J. Y., Park, G. M., Kim, Y. H., & Choe, J. (2016). Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans. Journal of Diabetes, 8(5), 657-66. https://doi.org/10.1111/1753-0407.12343
Kim HK, et al. Association of Prediabetes, Defined By Fasting Glucose, HbA1c Only, or Combined Criteria, With the Risk of Cardiovascular Disease in Koreans. J Diabetes. 2016;8(5):657-66. PubMed PMID: 26355268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans. AU - Kim,Hong-Kyu, AU - Lee,Jung Bok, AU - Kim,Seon Ha, AU - Jo,Min-Woo, AU - Kim,Eun Hee, AU - Hwang,Jenie Yoonoo, AU - Bae,Sung Jin, AU - Jung,Chang Hee, AU - Lee,Woo Je, AU - Park,Joong-Yeol, AU - Park,Gyung-Min, AU - Kim,Young-Hak, AU - Choe,Jaewon, Y1 - 2016/02/03/ PY - 2015/02/27/received PY - 2015/07/02/revised PY - 2015/09/06/accepted PY - 2015/9/11/entrez PY - 2015/9/12/pubmed PY - 2017/4/19/medline KW - HbA1c KW - Koreans KW - cardiovascular disease KW - fasting glucose KW - prediabetes KW - 心血管疾病 KW - 空腹血糖 KW - 糖尿病前期。 KW - 韩国人 SP - 657 EP - 66 JF - Journal of diabetes JO - J Diabetes VL - 8 IS - 5 N2 - BACKGROUND: The aim of the present study was to compare the association between cardiovascular diseases (CVD) and prediabetes defined by either fasting plasma glucose (FPG), HbA1c, or their combination in a Korean population. METHODS: In all, 76 434 South Koreans who voluntarily underwent a general health examination in the Health Screening & Promotion Center (Asan Medical Center) were analyzed after excluding patients with a previous history of CVD. Cardiovascular events and death due to CVD during a median follow-up period of 3.1 years (interquartile range 1.9-4.3 years) were identified from the Nationwide Health Insurance Claims Database and death certificates using ICD-10 codes. RESULTS: Age- and sex-adjusted hazard ratios (HRs) for overall CVD events were significantly greater for subjects with prediabetes defined by FPG only (HR 1.19; 95% confidence interval [CI] 1.08-1.31), HbA1c only (HR 1.28; 95% CI 1.16-1.42), and combined criteria (HR 1.20; 95% CI 1.09-1.32) compared with the normoglycemic group. After adjusting for multiple conventional risk factors (e.g. hypertension, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, smoking status, family history of CVD, and BMI), the HRs for overall CVD were significantly increased only for participants with prediabetes defined by HbA1c. Age- and sex-adjusted HRs for major ischemic heart disease events were significantly increased for subjects with prediabetes defined either by HbA1c or combined criteria. Similarly, age- and sex-adjusted HRs for percutaneous coronary intervention were significantly higher for subjects with prediabetes defined by HbA1c only. For diabetes, the multivariate-adjusted HRs for all outcomes were significantly increased by all three criteria. CONCLUSIONS: Adding an HbA1c criterion when defining prediabetes in Koreans can help identify individuals with an increased risk of CVD. SN - 1753-0407 UR - https://www.unboundmedicine.com/medline/citation/26355268/Association_of_prediabetes_defined_by_fasting_glucose_HbA1c_only_or_combined_criteria_with_the_risk_of_cardiovascular_disease_in_Koreans_ L2 - https://doi.org/10.1111/1753-0407.12343 DB - PRIME DP - Unbound Medicine ER -