Association of variability in hemoglobin A1c with cardiovascular diseases and mortality in Chinese patients with type 2 diabetes mellitus - A retrospective population-based cohort study

J Diabetes Complications. 2016 Sep-Oct;30(7):1240-7. doi: 10.1016/j.jdiacomp.2016.05.024. Epub 2016 May 31.

Abstract

Aims: This study aimed to investigate the association between variability in HbA1c and incidence of cardiovascular disease (CVD) event and mortality among Chinese primary care patients with Type 2 diabetes mellitus (T2DM).

Methods: A retrospective cohort study was conducted on 91,866 T2DM patients aged ≥18years without any history of CVD. Variability in HbA1c, was measured by standard deviation (SD), associated with the risks of CVD and all-cause mortality were evaluated using Cox proportional hazards regression analysis by age groups ( 65 and ≥ 65 years old)." to "Variability in HbA1c was measured by standard deviation (SD) The association between Variability in HbA1c and the incidence of CVD and all-cause mortality were evaluated using Cox proportional hazards regression analysis by age groups ( 65 and ≥ 65 years old).

Results: Over a median follow-up of 58.5months, our study identified a positive linear relationship between variability in HbA1c and incidence of CVD and all-cause mortality in the younger and older groups. For every 1-SD increase in HbA1c, the risk of CVD events in the older group only increased by 15.2% (95% CI: 1.026-1.293), and the risks of all-cause mortality in both age groups increased by 49.5% (95% CI: 1.154-1.936) and 77.8% (95% CI: 1.563-2.024), respectively.

Conclusions: The HbA1c variability independently of the mean HbA1c level may provide additional valuable information as a potential predictor for the development of CVD and all-cause mortality in diabetic patients, particularly for the elderly patients.

Keywords: Cardiovascular diseases; Diabetes mellitus; HbA1c; Mortality; Variability.

MeSH terms

  • Aged
  • Asian People
  • Cardiovascular Diseases / ethnology*
  • China / epidemiology
  • Diabetes Mellitus, Type 2 / ethnology*
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis*
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Retrospective Studies
  • Risk Factors

Substances

  • Glycated Hemoglobin A