Haemoglobin A1c even within non-diabetic level is a predictor of cardiovascular disease in a general Japanese population: the Hisayama Study.
Haemoglobin A1c even within non-diabetic level is a predictor of cardiovascular disease in a general Japanese population: the Hisayama Study.
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即使在非糖尿病水平内，血红蛋白 A1c 也是日本普通人群心血管疾病的预测因子：久山研究。
DOI：
10.1186/1475-2840-12-164
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发表时间：
2013-11-07
影响因子：
9.3
通讯作者：
Kiyohara Y
中科院分区：
文献类型：
--
作者：
Ikeda F;Doi Y;Ninomiya T;Hirakawa Y;Mukai N;Hata J;Shikata K;Yoshida D;Matsumoto T;Kitazono T;Kiyohara Y
关于亚洲人血红蛋白A1 c（HbA 1c）对心血管疾病（CVD）的预测能力的信息很少。在一项针对特定社区居住日本人群的前瞻性研究中，研究HbA 1c识别发生CVD风险较高受试者的区分能力。共2，851例40-79岁的受试者被分层为5组（HbA 1c水平≤ 5.0、5.1-5.4、5.5-6.4和≥ 6.5%，以及接受降糖药物治疗的组），并前瞻性随访7年（2002-2009年）。在随访期间，119名受试者发生了CVD。与HbA 1c水平≤ 5.0%的受试者相比，HbA 1c水平为5.5-6.4和≥ 6.5%且接受糖尿病药物治疗的受试者的CVD多变量校正风险显著增加（风险比，5.5-6.4%组为2.26 [95%置信区间，1.29-3.95]; ≥ 6.5%组为4.43 [2.09-9.37];降糖药物组为5.15 [2.65-10.0]）。关于CVD亚型，HbA 1c水平与冠心病（CHD）和缺血性卒中风险之间的正相关性也很显著，但在出血性卒中中未观察到此类相关性。通过将HbA 1c值添加到包括其他风险因素的模型中，发生CVD的C统计量显著增加（0.789 vs. 0762，p = 0.006），净重新分类改善为0.105（p = 0.004）。我们的研究结果表明，HbA 1c水平升高是CVD的独立危险因素，尤其是CHD和缺血性卒中，并且在具有传统危险因素的模型中添加HbA 1c显著提高了CVD的预测能力。
There is little information about predictive ability of haemoglobin A1c (HbA1c) for cardiovascular disease (CVD) in Asians. To investigate the discriminatory ability of HbA1c to identify subjects who are at greater risk of developing CVD in a prospective study of a defined community-dwelling Japanese population. A total of 2,851 subjects aged 40–79 years were stratified into five groups (HbA1c levels with ≤ 5.0, 5.1–5.4, 5.5–6.4, and ≥ 6.5% and a group with antidiabetic medication) and followed up prospectively for 7 years (2002–2009). During the follow-up, 119 subjects developed CVD. The multivariable-adjusted risk of CVD was significantly increased in subjects with HbA1c levels of 5.5–6.4 and ≥ 6.5% and diabetic medication compared to HbA1c level with ≤ 5.0% (hazard ratio, 2.26 [95% confidence interval, 1.29–3.95] for the 5.5–6.4%; 4.43 [2.09–9.37] for the ≥ 6.5%; and 5.15 [2.65–10.0] for the antidiabetic medication group). With regard to CVD subtype, the positive associations between HbA1c levels and the risk of coronary heart disease (CHD) and ischaemic stroke were also significant, but no such associations were seen for haemorrhagic stroke. The C statistic for developing CVD was significantly increased by adding HbA1c values to the model including other risk factors (0.789 vs. 0762, p = 0.006), and the net reclassification improvement was 0.105 (p = 0.004). Our findings suggest that elevated HbA1c levels are an independent risk factor for CVD, especially CHD and ischaemic stroke, and that the addition of HbA1c to the model with traditional risk factors significantly improves the predictive ability of CVD.
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影响因子：
2
作者：
Pencina, Michael J.;D'Agostino, Ralph B., Sr.;Steyerberg, Ewout W.
通讯作者：
Steyerberg, Ewout W.
影响因子：
9.3
作者：
Fukushima Y;Daida H;Morimoto T;Kasai T;Miyauchi K;Yamagishi S;Takeuchi M;Hiro T;Kimura T;Nakagawa Y;Yamagishi M;Ozaki Y;Matsuzaki M;JAPAN-ACS Investigators
通讯作者：
JAPAN-ACS Investigators
影响因子：
48
作者：
Selvin, E;Coresh, J;Sharrett, AR
通讯作者：
Sharrett, AR
影响因子：
16.2
作者：
Brewer, Naomi;Wright, Craig S.;Jeffreys, Mona
通讯作者：
Jeffreys, Mona
影响因子：
8.2
作者：
Nakanishi, S;Yamada, M;Suzuki, G
通讯作者：
Suzuki, G