No racial differences in the association of glycated hemoglobin with kidney disease and cardiovascular outcomes.
No racial differences in the association of glycated hemoglobin with kidney disease and cardiovascular outcomes.
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DOI：
10.2337/dc12-2715
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发表时间：
2013-10
期刊：
影响因子：
16.2
通讯作者：
Brancati FL
中科院分区：
文献类型：
--
作者：
Selvin E;Rawlings AM;Bergenstal RM;Coresh J;Brancati FL
关于HbA 1c中已确立的种族差异的临床意义存在争议。我们比较了社区中黑人和白色人的HbA 1c和空腹血糖的糖尿病诊断类别与临床结局的相关性。我们对社区动脉粥样硬化风险研究中没有糖尿病或心血管疾病的参与者进行了前瞻性队列分析。我们分别在2，484名黑人和8，593名白色参与者中检查了HbA 1c（<5.7%，5.7- 6.4%，≥6.5%）和空腹血糖（<100，100-125，≥126 mg/dL）的临床分类与结果的相关性，并测试了种族相互作用。与白人相比，黑人的基线特征存在显著差异，包括HbA 1c（5.8 vs. 5.4%; P < 0.001）。在18年的随访中，无论是黑人还是白人，在HbA 1c的各个类别中，肾脏疾病、致死性和非致死性冠心病以及中风的风险都有增加的趋势。除全因死亡率外，黑人和白人中HbA 1c类别的每个结局的校正风险比相似（交互作用P>0.05）。关联模式相似，但较弱，空腹血糖。与黑人相比，白人的HbA 1c和空腹血糖与全因死亡率的相关性更强，这在很大程度上是由心血管死亡率的种族差异解释的。HbA 1c是黑人和白色成人血管结局和死亡率的风险因素。HbA 1c的相关模式与空腹血糖相似或更强。关于长期结果，我们的研究结果支持对黑人和白人的HbA 1c进行类似的解释，用于糖尿病的诊断和治疗。
There is debate regarding the clinical significance of well-established racial differences in HbA1c. We compared the associations of diabetes diagnostic categories for HbA1c and fasting glucose with clinical outcomes in black and white persons in the community. We conducted a prospective cohort analysis of participants without diabetes or cardiovascular disease from the Atherosclerosis Risk in Communities study. We examined the associations of clinical categories of HbA1c (<5.7%, 5.7–6.4%, ≥6.5%) and fasting glucose (<100, 100–125, ≥126 mg/dL) with outcomes separately among 2,484 black and 8,593 white participants and tested for race interactions. Baseline characteristics differed significantly in blacks compared with whites, including HbA1c (5.8 vs. 5.4%; P < 0.001). During 18 years of follow-up, there were trends of increased risk of kidney disease, fatal and nonfatal coronary heart disease, and stroke across categories of HbA1c in both blacks and whites. The adjusted hazard ratios for each outcome across categories of HbA1c were similar in blacks and whites (P for interaction >0.05) except for all-cause mortality. Patterns of association were similar, but weaker, for fasting glucose. HbA1c and fasting glucose both were more strongly associated with all-cause mortality in whites compared with blacks, largely explained by racial differences in the rate of cardiovascular deaths. HbA1c is a risk factor for vascular outcomes and mortality in both black and white adults. Patterns of association for HbA1c were similar to or stronger than those for fasting glucose. With respect to long-term outcomes, our findings support a similar interpretation of HbA1c in blacks and whites for diagnosis and treatment of diabetes mellitus.
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影响因子：
7.7
作者：
Borg R;Kuenen JC;Carstensen B;Zheng H;Nathan DM;Heine RJ;Nerup J;Borch-Johnsen K;Witte DR;ADAG Study Group
通讯作者：
ADAG Study Group
影响因子：
3.4
作者：
Likhari, Taruna;Gama, Rousseau
通讯作者：
Gama, Rousseau
影响因子：
3.5
作者：
Likhari, T.;Gama, R.
通讯作者：
Gama, R.
影响因子：
16.2
作者：
Bower JK;Brancati FL;Selvin E
通讯作者：
Selvin E
影响因子：
16.2
作者：
Bloomgarden, Zachary T
通讯作者：
Bloomgarden, Zachary T