Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus
Aim To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients. Method We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis betwee...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2024-11, Vol.26 (11), p.5138-5146 |
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| container_title | Diabetes, obesity & metabolism |
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| creator | Wang, Yuan Chin, Weng Yee Lam, Cindy Lo Kuen Wan, Eric Yuk Fai |
| description | Aim
To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients.
Method
We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c ( |
| doi_str_mv | 10.1111/dom.15856 |
| format | Article |
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To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients.
Method
We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c (<7%; 7%–7.9%; ≥8%) and age (<65; ≥65 years), and then clustered into classes by HbA1c trajectory and CVD incidence over the 12‐year follow‐up period using joint latent class mixture models. We explored the HbA1c trajectories and CVD incidences in each latent class. Multinomial logistic regression was used to compare the baseline characteristics among different latent classes.
Results
A total of 128 843 T2DM patients were included with a median follow‐up period of 11.7 years. Ten latent classes were identified in patients with baseline HbA1c ≥ 8% and age <65 years, while seven classes were identified in the other five groups. Among all the identified latent classes, patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, had higher CVD incidences. Male patients, and patients with higher baseline HbA1c and use of antidiabetic drugs were more likely to have a fluctuating HbA1c trajectory. More specifically, patients aged < 65 years with younger age or a smoking habit, and patients aged ≥ 65 years with a longer duration of T2DM were more likely to have a fluctuating HbA1c trajectory.
Conclusion
We found that T2DM patients with fluctuating HbA1c trajectories could have a higher CVD risk. Different trajectory‐associated characteristics in age subgroups highlight the need for individualized management of T2DM patients.</description><identifier>ISSN: 1462-8902</identifier><identifier>ISSN: 1463-1326</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.15856</identifier><identifier>PMID: 39161066</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Age ; Cardiovascular disease ; Cardiovascular diseases ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; haemoglobin A1c ; Hemoglobin ; Regression analysis ; trajectory ; type 2 diabetes mellitus</subject><ispartof>Diabetes, obesity & metabolism, 2024-11, Vol.26 (11), p.5138-5146</ispartof><rights>2024 The Author(s). published by John Wiley & Sons Ltd.</rights><rights>2024 The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2436-81151289a1c3e32663e671989f7011dac72574e8b9c643cb439db30262f429a13</cites><orcidid>0000-0002-6275-1147</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.15856$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.15856$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39161066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Yuan</creatorcontrib><creatorcontrib>Chin, Weng Yee</creatorcontrib><creatorcontrib>Lam, Cindy Lo Kuen</creatorcontrib><creatorcontrib>Wan, Eric Yuk Fai</creatorcontrib><title>Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aim
To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients.
Method
We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c (<7%; 7%–7.9%; ≥8%) and age (<65; ≥65 years), and then clustered into classes by HbA1c trajectory and CVD incidence over the 12‐year follow‐up period using joint latent class mixture models. We explored the HbA1c trajectories and CVD incidences in each latent class. Multinomial logistic regression was used to compare the baseline characteristics among different latent classes.
Results
A total of 128 843 T2DM patients were included with a median follow‐up period of 11.7 years. Ten latent classes were identified in patients with baseline HbA1c ≥ 8% and age <65 years, while seven classes were identified in the other five groups. Among all the identified latent classes, patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, had higher CVD incidences. Male patients, and patients with higher baseline HbA1c and use of antidiabetic drugs were more likely to have a fluctuating HbA1c trajectory. More specifically, patients aged < 65 years with younger age or a smoking habit, and patients aged ≥ 65 years with a longer duration of T2DM were more likely to have a fluctuating HbA1c trajectory.
Conclusion
We found that T2DM patients with fluctuating HbA1c trajectories could have a higher CVD risk. Different trajectory‐associated characteristics in age subgroups highlight the need for individualized management of T2DM patients.</description><subject>Age</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>haemoglobin A1c</subject><subject>Hemoglobin</subject><subject>Regression analysis</subject><subject>trajectory</subject><subject>type 2 diabetes mellitus</subject><issn>1462-8902</issn><issn>1463-1326</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><recordid>eNp1kU1PxCAQhonR-LF68A8YEi96qDLQ0vZo1s9E40XPhNKpy6YtK7Ru9t_LuurBxLkwCQ_vvMxLyDGwC4h1WbvuArIik1tkH1IpEhBcbn_1PClKxvfIQQhzxlgqinyX7IkSJDAp94l78XqOZnB-RV1DZxo799a6yvb0CgzVfU1tb2yNvcE1YLSvrfvQwYyt9rS2AXXAyNCFHiz2Q6BLO8zosFog5fFeVzhgoB22rR3GcEh2Gt0GPPo-J-T19uZlep88Pt89TK8eE8NTIZMCIANelBqMwPgZKVDmUBZlkzOAWpucZ3mKRVUamQpTpaKsK8G45E3K4ysxIWcb3YV37yOGQXU2mGhC9-jGoAQr04LHFWQRPf2Dzt3o--hOCQCeSx7nRup8QxnvQvDYqIW3nfYrBUytU1AxBfWVQmRPvhXHqsP6l_xZewQuN8DStrj6X0ldPz9tJD8B3ZSPsw</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Wang, Yuan</creator><creator>Chin, Weng Yee</creator><creator>Lam, Cindy Lo Kuen</creator><creator>Wan, Eric Yuk Fai</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6275-1147</orcidid></search><sort><creationdate>202411</creationdate><title>Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus</title><author>Wang, Yuan ; Chin, Weng Yee ; Lam, Cindy Lo Kuen ; Wan, Eric Yuk Fai</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2436-81151289a1c3e32663e671989f7011dac72574e8b9c643cb439db30262f429a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Age</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>haemoglobin A1c</topic><topic>Hemoglobin</topic><topic>Regression analysis</topic><topic>trajectory</topic><topic>type 2 diabetes mellitus</topic><toplevel>online_resources</toplevel><creatorcontrib>Wang, Yuan</creatorcontrib><creatorcontrib>Chin, Weng Yee</creatorcontrib><creatorcontrib>Lam, Cindy Lo Kuen</creatorcontrib><creatorcontrib>Wan, Eric Yuk Fai</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Yuan</au><au>Chin, Weng Yee</au><au>Lam, Cindy Lo Kuen</au><au>Wan, Eric Yuk Fai</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2024-11</date><risdate>2024</risdate><volume>26</volume><issue>11</issue><spage>5138</spage><epage>5146</epage><pages>5138-5146</pages><issn>1462-8902</issn><issn>1463-1326</issn><eissn>1463-1326</eissn><abstract>Aim
To evaluate the association between changes in haemoglobin A1c (HbA1c) and the concurrent incidence of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM) patients.
Method
We conducted a retrospective cohort study among T2DM patients with HbA1c measurement after T2DM diagnosis between August 2009 and September 2010. The patients were classified into six subgroups based on baseline HbA1c (<7%; 7%–7.9%; ≥8%) and age (<65; ≥65 years), and then clustered into classes by HbA1c trajectory and CVD incidence over the 12‐year follow‐up period using joint latent class mixture models. We explored the HbA1c trajectories and CVD incidences in each latent class. Multinomial logistic regression was used to compare the baseline characteristics among different latent classes.
Results
A total of 128 843 T2DM patients were included with a median follow‐up period of 11.7 years. Ten latent classes were identified in patients with baseline HbA1c ≥ 8% and age <65 years, while seven classes were identified in the other five groups. Among all the identified latent classes, patients with fluctuating HbA1c trajectories, characterized by alternating periods of increase and decrease, had higher CVD incidences. Male patients, and patients with higher baseline HbA1c and use of antidiabetic drugs were more likely to have a fluctuating HbA1c trajectory. More specifically, patients aged < 65 years with younger age or a smoking habit, and patients aged ≥ 65 years with a longer duration of T2DM were more likely to have a fluctuating HbA1c trajectory.
Conclusion
We found that T2DM patients with fluctuating HbA1c trajectories could have a higher CVD risk. Different trajectory‐associated characteristics in age subgroups highlight the need for individualized management of T2DM patients.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>39161066</pmid><doi>10.1111/dom.15856</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6275-1147</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Cardiovascular disease Cardiovascular diseases Diabetes Diabetes mellitus (non-insulin dependent) haemoglobin A1c Hemoglobin Regression analysis trajectory type 2 diabetes mellitus |
| title | Trajectory of haemoglobin A1c and incidence of cardiovascular disease in patients with type 2 diabetes mellitus |
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