1. Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, 510120 China
2. Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, 510120 China
3. Department of Internal Medicine, Dongguan Hengli Hospital, Dongguan, 523460 China
4. Radiotherapy Department, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, 510120 China
5. Department of Clinical Laboratory, Dongguan Hengli Hospital, Dongguan, 523460 China
* Guicheng Peng and Maohuan Lin contributed equally to the development of this research study.
Objective: To investigate the significance of hemoglobin A1c (HbA1c) in cardiovascular and metabolic risk stratification among diabetes and non-diabetes in southern Chinese.
Methods: Indigenous adults (aged more than or equal to 35 years) without known diabetes were enrolled in the cross-sectional survey. According to oral glucose tolerance test (OGTT), participants were categorized into OGTT-negative group and OGTT-positive group. Cardiovascular and metabolic risk profile was compared between different HbA1c levels (≥ 6.5% vs. < 6.5%) in each group.
Results: The prevalence of OGTT-diagnosed diabetes was 6.45% (422/6540). In OGTT-negative group, subjects with HbA1c ≥ 6.5% were older, had higher prevalence of coronary heart disease, current smoking, hypertension, obesity and abdominal obesity. They also had higher body weight, waist-hip ratio, body mass index, glucose levels (fasting plasma glucose, 2-hour plasma glucose and HbA1c), and lipid levels (total cholesterol and low density lipoprotein cholesterol). In OGTT-positive group, patients with HbA1c ≥ 6.5% identified less cardiovascular and metabolic risk file than that in OGTT-negative group.
Conclusions: Subjects with HbA1c ≥ 6.5% have more unfavorable cardiovascular and metabolic risk profile than those with HbA1c < 6.5%, especially in OGTT-negative population. More attention should be paid to this subgroup in clinical practice.
Keywords: Diabetes mellitus, diagnosis, hemoglobin A1c, oral glucose tolerance test, risk stratification