학술논문
Glycated Hemoglobin and All-Cause and Cause-Specific Mortality Among Adults With and Without Diabetes
CLINICAL RESEARCH ARTICLE
CLINICAL RESEARCH ARTICLE
Document Type
Clinical report
Author
Source
Journal of Clinical Endocrinology & Metabolism. August 2019, Vol. 104 Issue 8, p3345, 10 p.
Subject
Language
English
ISSN
0021-972X
Abstract
Glycated Hb (Hb[A.sub.1c]) represents average endogenous exposure to glucose for the prior 2 to 3 months (1). This biomarker has received much attention for its established relationship to type 2 [...]
ORCiD numbers: 0000-0002-6537-6215 (C. Mao). Context: The patterns of associations between glycated Hb (Hb[A.sub.1c]) and mortality are still unclear. Objective: To explore the extent to which ranges of Hb[A.sub.1c] levels are associated with the risk of mortality among participants with and without diabetes. Design, Setting, and Patients: This was a nationwide, community-based prospective cohort study. Included were 15,869 participants (median age 64 years) of the Health and Retirement Study, with available Hb[A.sub.1c] data and without a history of cancer. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for mortality. Results: A total of 2133 participants died during a median follow-up of 5.8 years. In participants with diabetes, those with an HbA1c level of 6.5% were at the lowest risk of all-cause mortality. When Hb[A.sub.1c] level was 7.4%, the increased all-cause mortality risk became statistically significant as compared with an Hb[A.sub.1c] level of 6.5%. As for participants without diabetes, those with an Hb[A.sub.1c] level of 5.4% were at the lowest risk of all-cause mortality. When the Hb[A.sub.1c] level was Conclusions: A U-shaped and reverse J-shaped association for all-cause mortality was found among participants with and without diabetes. The corresponding optimal ranges for overall survival are predicted to be 5.6% and 7.4% and 5.0% and 6.5%, respectively. (J Clin Endocrinol Metab 104: 3345-3354, 2019)
ORCiD numbers: 0000-0002-6537-6215 (C. Mao). Context: The patterns of associations between glycated Hb (Hb[A.sub.1c]) and mortality are still unclear. Objective: To explore the extent to which ranges of Hb[A.sub.1c] levels are associated with the risk of mortality among participants with and without diabetes. Design, Setting, and Patients: This was a nationwide, community-based prospective cohort study. Included were 15,869 participants (median age 64 years) of the Health and Retirement Study, with available Hb[A.sub.1c] data and without a history of cancer. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for mortality. Results: A total of 2133 participants died during a median follow-up of 5.8 years. In participants with diabetes, those with an HbA1c level of 6.5% were at the lowest risk of all-cause mortality. When Hb[A.sub.1c] level was 7.4%, the increased all-cause mortality risk became statistically significant as compared with an Hb[A.sub.1c] level of 6.5%. As for participants without diabetes, those with an Hb[A.sub.1c] level of 5.4% were at the lowest risk of all-cause mortality. When the Hb[A.sub.1c] level was Conclusions: A U-shaped and reverse J-shaped association for all-cause mortality was found among participants with and without diabetes. The corresponding optimal ranges for overall survival are predicted to be 5.6% and 7.4% and 5.0% and 6.5%, respectively. (J Clin Endocrinol Metab 104: 3345-3354, 2019)