Hemoglobin a1c and the progression of coronary artery calcification among adults without diabetes

April P. Carson, Michael W. Steffes, J. Jeffrey Carr, Yongin Kim, Myron D. Gross, Mercedes R. Carnethon, Jared P. Reis, Catherine M. Loria, David R. Jacobs, Cora E. Lewis

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECTIVE : Higher levels of hemoglobin A1c (HbA1c) are associated with increased cardiovascular disease risk among individuals without diabetes and may also be positively associated with coronary artery calcification (CAC). This study investigated the association of HbA1c with CAC progression in the Coronary Artery Risk Development in Young Adults study.

RESEARCH DESIGN AND METHODS : We included 2,076 participants with HbA1c and noncontrast computed tomography (CT) assessed at baseline (2005-2006), and CT repeated 5 years later (2010- 2011). CAC progression was defined as 1) incident CAC (increase >0 Agatston units among those with no CAC at baseline), 2) any CAC progression (increase >10 Agatston units between examinations), and 3) advanced CAC progression (increase >100 Agatston units between examinations).

RESULTS : During the 5-year follow-up period, 12.9% of participants without baseline CAC developed incident CAC; among all participants, 18.2% had any CAC progression and 5.4% had advanced CAC progression. Higher HbA1c was associated with incident CAC (risk ratio [RR] = 1.45; 95% CI 1.02, 2.06), any CAC progression (RR = 1.51; 95% CI 1.16, 1.96), and advanced CAC progression (RR = 2.42; 95% CI 1.47, 3.99) after adjustment for sociodemographic factors. Additional adjustment for cardiovascular risk factors attenuated the associations of HbA1c with incident CAC (RR = 1.05; 95% CI 0.74, 1.49) and any CAC progression (RR = 1.13; 95% CI 0.87, 1.47). In contrast, the association of HbA1c with advanced CAC progression persisted in multivariable adjusted models (RR = 1.78; 95% CI 1.08, 2.95).

CONCLUSIONS : Higher HbA1c was independently associated with advanced CAC progression among individuals without diabetes, while the associations with incident CAC and any CAC progression were accounted for by other established cardiovascular risk factors.

Original languageEnglish (US)
Pages (from-to)66-71
Number of pages6
JournalDiabetes care
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Coronary Vessels
Hemoglobins
Odds Ratio
Tomography

Cite this

Hemoglobin a1c and the progression of coronary artery calcification among adults without diabetes. / Carson, April P.; Steffes, Michael W.; Carr, J. Jeffrey; Kim, Yongin; Gross, Myron D.; Carnethon, Mercedes R.; Reis, Jared P.; Loria, Catherine M.; Jacobs, David R.; Lewis, Cora E.

In: Diabetes care, Vol. 38, No. 1, 01.01.2015, p. 66-71.

Research output: Contribution to journalArticle

Carson, April P. ; Steffes, Michael W. ; Carr, J. Jeffrey ; Kim, Yongin ; Gross, Myron D. ; Carnethon, Mercedes R. ; Reis, Jared P. ; Loria, Catherine M. ; Jacobs, David R. ; Lewis, Cora E. / Hemoglobin a1c and the progression of coronary artery calcification among adults without diabetes. In: Diabetes care. 2015 ; Vol. 38, No. 1. pp. 66-71.
@article{ab9c62a0cfe04916a5ba7d08de08dcf9,
title = "Hemoglobin a1c and the progression of coronary artery calcification among adults without diabetes",
abstract = "OBJECTIVE : Higher levels of hemoglobin A1c (HbA1c) are associated with increased cardiovascular disease risk among individuals without diabetes and may also be positively associated with coronary artery calcification (CAC). This study investigated the association of HbA1c with CAC progression in the Coronary Artery Risk Development in Young Adults study.RESEARCH DESIGN AND METHODS : We included 2,076 participants with HbA1c and noncontrast computed tomography (CT) assessed at baseline (2005-2006), and CT repeated 5 years later (2010- 2011). CAC progression was defined as 1) incident CAC (increase >0 Agatston units among those with no CAC at baseline), 2) any CAC progression (increase >10 Agatston units between examinations), and 3) advanced CAC progression (increase >100 Agatston units between examinations).RESULTS : During the 5-year follow-up period, 12.9{\%} of participants without baseline CAC developed incident CAC; among all participants, 18.2{\%} had any CAC progression and 5.4{\%} had advanced CAC progression. Higher HbA1c was associated with incident CAC (risk ratio [RR] = 1.45; 95{\%} CI 1.02, 2.06), any CAC progression (RR = 1.51; 95{\%} CI 1.16, 1.96), and advanced CAC progression (RR = 2.42; 95{\%} CI 1.47, 3.99) after adjustment for sociodemographic factors. Additional adjustment for cardiovascular risk factors attenuated the associations of HbA1c with incident CAC (RR = 1.05; 95{\%} CI 0.74, 1.49) and any CAC progression (RR = 1.13; 95{\%} CI 0.87, 1.47). In contrast, the association of HbA1c with advanced CAC progression persisted in multivariable adjusted models (RR = 1.78; 95{\%} CI 1.08, 2.95).CONCLUSIONS : Higher HbA1c was independently associated with advanced CAC progression among individuals without diabetes, while the associations with incident CAC and any CAC progression were accounted for by other established cardiovascular risk factors.",
author = "Carson, {April P.} and Steffes, {Michael W.} and Carr, {J. Jeffrey} and Yongin Kim and Gross, {Myron D.} and Carnethon, {Mercedes R.} and Reis, {Jared P.} and Loria, {Catherine M.} and Jacobs, {David R.} and Lewis, {Cora E.}",
year = "2015",
month = "1",
day = "1",
doi = "10.2337/dc14-0360",
language = "English (US)",
volume = "38",
pages = "66--71",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "1",

}

TY - JOUR

T1 - Hemoglobin a1c and the progression of coronary artery calcification among adults without diabetes

AU - Carson, April P.

AU - Steffes, Michael W.

AU - Carr, J. Jeffrey

AU - Kim, Yongin

AU - Gross, Myron D.

AU - Carnethon, Mercedes R.

AU - Reis, Jared P.

AU - Loria, Catherine M.

AU - Jacobs, David R.

AU - Lewis, Cora E.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - OBJECTIVE : Higher levels of hemoglobin A1c (HbA1c) are associated with increased cardiovascular disease risk among individuals without diabetes and may also be positively associated with coronary artery calcification (CAC). This study investigated the association of HbA1c with CAC progression in the Coronary Artery Risk Development in Young Adults study.RESEARCH DESIGN AND METHODS : We included 2,076 participants with HbA1c and noncontrast computed tomography (CT) assessed at baseline (2005-2006), and CT repeated 5 years later (2010- 2011). CAC progression was defined as 1) incident CAC (increase >0 Agatston units among those with no CAC at baseline), 2) any CAC progression (increase >10 Agatston units between examinations), and 3) advanced CAC progression (increase >100 Agatston units between examinations).RESULTS : During the 5-year follow-up period, 12.9% of participants without baseline CAC developed incident CAC; among all participants, 18.2% had any CAC progression and 5.4% had advanced CAC progression. Higher HbA1c was associated with incident CAC (risk ratio [RR] = 1.45; 95% CI 1.02, 2.06), any CAC progression (RR = 1.51; 95% CI 1.16, 1.96), and advanced CAC progression (RR = 2.42; 95% CI 1.47, 3.99) after adjustment for sociodemographic factors. Additional adjustment for cardiovascular risk factors attenuated the associations of HbA1c with incident CAC (RR = 1.05; 95% CI 0.74, 1.49) and any CAC progression (RR = 1.13; 95% CI 0.87, 1.47). In contrast, the association of HbA1c with advanced CAC progression persisted in multivariable adjusted models (RR = 1.78; 95% CI 1.08, 2.95).CONCLUSIONS : Higher HbA1c was independently associated with advanced CAC progression among individuals without diabetes, while the associations with incident CAC and any CAC progression were accounted for by other established cardiovascular risk factors.

AB - OBJECTIVE : Higher levels of hemoglobin A1c (HbA1c) are associated with increased cardiovascular disease risk among individuals without diabetes and may also be positively associated with coronary artery calcification (CAC). This study investigated the association of HbA1c with CAC progression in the Coronary Artery Risk Development in Young Adults study.RESEARCH DESIGN AND METHODS : We included 2,076 participants with HbA1c and noncontrast computed tomography (CT) assessed at baseline (2005-2006), and CT repeated 5 years later (2010- 2011). CAC progression was defined as 1) incident CAC (increase >0 Agatston units among those with no CAC at baseline), 2) any CAC progression (increase >10 Agatston units between examinations), and 3) advanced CAC progression (increase >100 Agatston units between examinations).RESULTS : During the 5-year follow-up period, 12.9% of participants without baseline CAC developed incident CAC; among all participants, 18.2% had any CAC progression and 5.4% had advanced CAC progression. Higher HbA1c was associated with incident CAC (risk ratio [RR] = 1.45; 95% CI 1.02, 2.06), any CAC progression (RR = 1.51; 95% CI 1.16, 1.96), and advanced CAC progression (RR = 2.42; 95% CI 1.47, 3.99) after adjustment for sociodemographic factors. Additional adjustment for cardiovascular risk factors attenuated the associations of HbA1c with incident CAC (RR = 1.05; 95% CI 0.74, 1.49) and any CAC progression (RR = 1.13; 95% CI 0.87, 1.47). In contrast, the association of HbA1c with advanced CAC progression persisted in multivariable adjusted models (RR = 1.78; 95% CI 1.08, 2.95).CONCLUSIONS : Higher HbA1c was independently associated with advanced CAC progression among individuals without diabetes, while the associations with incident CAC and any CAC progression were accounted for by other established cardiovascular risk factors.

UR - http://www.scopus.com/inward/record.url?scp=84920051174&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920051174&partnerID=8YFLogxK

U2 - 10.2337/dc14-0360

DO - 10.2337/dc14-0360

M3 - Article

VL - 38

SP - 66

EP - 71

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 1

ER -