Glycemic control and coronary heart disease risk in persons with and without diabetes - The atherosclerosis risk in communities study
Glycemic control and coronary heart disease risk in persons with and without diabetes - The atherosclerosis risk in communities study
复制标题
DOI：
10.1001/archinte.165.16.1910
复制
发表时间：
2005-09-12
影响因子：
--
通讯作者：
Steffes, MW
中科院分区：
文献类型：
--
作者：
Selvin, E;Coresh, J;Steffes, MW
背景：慢性高血糖被认为是冠心病(CHD)的诱因，但长期血糖控制的标志物--血红蛋白A(1c)(HbA(1c))水平在多大程度上与CHD风险独立相关尚不确定。方法：我们对1321名非糖尿病成年人进行了前瞻性病例队列研究，并对1626名成人糖尿病患者进行了社区动脉粥样硬化风险研究。结果：在成人糖尿病患者中，糖化血红蛋白(1c)水平最高的五分位数的相对危险度(RR)为2.37(95%可信区间，1.50~3.72)，调整CHD危险因素后的相对危险度(RR)为2.37(95%可信区间1.50~3.72)。在非糖尿病人群中，HBA(1c)水平最高五分之一的CHD调整RR为1.41(95%CI，0.90-2.30)，但在这组人群中存在非线性关系。在非糖尿病成人中，HbA(1c)水平与4.6%以下的冠心病风险无关，但与高于该水平的风险显著相关(P
Background: Chronic hyperglycemia has been hypothesized to contribute to coronary heart disease (CHD), but the extent to which hemoglobin A(1c) (HbA(1c)) level, a marker of long-term glycemic control, is independently related to CHD risk is uncertain.Methods: We conducted a prospective case-cohort study of 1321 adults without diabetes and a cohort study of 1626 adults with diabetes from the Atherosclerosis Risk in Communities Study. Using proportional hazards models, we assessed the relation between HbA(1c) level and incident CHD during 8 to 10 years of follow-up.Results: In adults with diabetes, the relative risk (RR) of CHD was 2.37 (95% confidence interval [CI], 1.50-3.72) for the highest quintile of HbA(1c) level compared with the lowest after adjustment for CHD risk factors. in persons without diabetes, the adjusted RR of CHD in the highest quintile of HbA(1c) level was 1.41 (95% CI, 0.90-2.30); however, there was evidence of a nonlinear relationship in this group. In nondiabetic adults, HbA(1c) level was not related to CHD risk below a level of 4.6% but was significantly related to risk above that level (P