The relationship between repeated measurements of HbA 1c and risk of coronary events among the common haptoglobin phenotype groups: the Action for Health in Diabetes (Look AHEAD) study
In the ACCORD study, participants with the haptoglobin (Hp) 2-2 phenotype and glycated hemoglobin (HbA ) ≥ 8.0% had a higher risk of coronary artery disease (CAD) compared to those with HbA 7.0-7.9%. However, this association was not observed in participants without the Hp2-2 phenotype. The optimal...
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| creator | Carew, A S Warren, R A Bancks, M P Espeland, M A Bahnson, J L Lewis, C L Levy, A P Sapp, J L Urquhart, R Wang, J L Rimm, E B Cahill, L E |
| description | In the ACCORD study, participants with the haptoglobin (Hp) 2-2 phenotype and glycated hemoglobin (HbA
) ≥ 8.0% had a higher risk of coronary artery disease (CAD) compared to those with HbA
7.0-7.9%. However, this association was not observed in participants without the Hp2-2 phenotype. The optimal glycemic target for CAD prevention for the Hp phenotypes remains uncertain and may vary based on demographic and clinical factors.
To investigate how reaching clinically relevant HbA
targets relates to the risk of CAD in different Hp phenotype groups among a diverse cohort of individuals with T2DM (the Look AHEAD study, HbA
≤ 11% at baseline).
Cox regression models with time-varying covariables were used to quantify the association between time-varying achieved HbA
( |
| doi_str_mv | 10.1186/s12933-024-02448-z |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed</sourceid><recordid>TN_cdi_pubmed_primary_39385258</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>39385258</sourcerecordid><originalsourceid>FETCH-pubmed_primary_393852583</originalsourceid><addsrcrecordid>eNqFj8tOwzAQRS0kRMvjB1igWcIiEOfRpuwiWpQFy-4rJ5k8aOyxbAcUvozPw6lgzWI0o6uj0bmM3fLwkfNs9WR5tInjIIySeZIs-DpjS56s0yDKknDBLq19D0O-zlb8gi3iTZylUZot2fe-QzA4CNeTsl2voUT3iah8qFE4rEGisKNBicpZoAaKMgdegVA1mN4e56giQ0qYCfDjRAlJqgXnX1ck_Q2d0I7agcpege5QkZs0Qmto1Pb5BObVbAANGShQDK4Dj2574XXQwv0b0RHyYpdvH8C6sZ6u2XkjBos3v_uK3b3u9i9FoMdSYn3Qppfe6PBXNf4X-AG_s2eL</addsrcrecordid><sourcetype>Index Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>The relationship between repeated measurements of HbA 1c and risk of coronary events among the common haptoglobin phenotype groups: the Action for Health in Diabetes (Look AHEAD) study</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>Springer Nature OA Free Journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Carew, A S ; Warren, R A ; Bancks, M P ; Espeland, M A ; Bahnson, J L ; Lewis, C L ; Levy, A P ; Sapp, J L ; Urquhart, R ; Wang, J L ; Rimm, E B ; Cahill, L E</creator><creatorcontrib>Carew, A S ; Warren, R A ; Bancks, M P ; Espeland, M A ; Bahnson, J L ; Lewis, C L ; Levy, A P ; Sapp, J L ; Urquhart, R ; Wang, J L ; Rimm, E B ; Cahill, L E</creatorcontrib><description>In the ACCORD study, participants with the haptoglobin (Hp) 2-2 phenotype and glycated hemoglobin (HbA
) ≥ 8.0% had a higher risk of coronary artery disease (CAD) compared to those with HbA
7.0-7.9%. However, this association was not observed in participants without the Hp2-2 phenotype. The optimal glycemic target for CAD prevention for the Hp phenotypes remains uncertain and may vary based on demographic and clinical factors.
To investigate how reaching clinically relevant HbA
targets relates to the risk of CAD in different Hp phenotype groups among a diverse cohort of individuals with T2DM (the Look AHEAD study, HbA
≤ 11% at baseline).
Cox regression models with time-varying covariables were used to quantify the association between time-varying achieved HbA
(< 6.5%, 6.5-6.9%, and ≥ 8.0% compared to 7.0-7.9%), updated at years 1-4, 6, 8, and 10, and incident CAD in the Hp2-2 (n = 1,587) and non-Hp2-2 (n = 2,944) phenotypes separately. Further pre-specified subgroup analyses by age, sex, history of cardiovascular disease (CVD), race, and diabetes duration were performed in each Hp phenotype group separately.
Compared with HbA
7.0-7.9%, having HbA
< 6.5% was associated with a 29% lower CAD risk among participants with the non-Hp2-2 phenotype (adjusted HR 0.71, 95% CI 0.55-0.90). In subgroup analyses, this association was present in participants with the non-Hp2-2 phenotype who were male (0.60, 0.44-0.83), who did not have a history of CVD (0.65, 0.47-0.90), who were aged ≥ 65 years (0.64, 0.44-0.94), who were White (0.68, 0.51-0.91), or who had diabetes duration > 10 years (0.58, 0.35-0.95). HbA
≥ 8.0% was associated with CAD risk only among participants with the Hp2-2 phenotype who had a history of CVD (1.79, 1.00-3.20). No associations were found between the other HbA
targets and CAD risk when participants with the Hp2-2 phenotype were grouped together or divided into subgroups.
The differences in our results compared to our previous findings may be due to variations in the study populations and factors associated with weight loss, making it difficult to draw definitive conclusions. Our current findings should be considered in the context of hypothesis generation, and ideally, will encourage additional research in this field.</description><identifier>EISSN: 1475-2840</identifier><identifier>DOI: 10.1186/s12933-024-02448-z</identifier><identifier>PMID: 39385258</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Biomarkers - blood ; Blood Glucose - metabolism ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - epidemiology ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - epidemiology ; Female ; Glycated Hemoglobin - metabolism ; Glycemic Control ; Haptoglobins - genetics ; Humans ; Hypoglycemic Agents - therapeutic use ; Incidence ; Male ; Middle Aged ; Phenotype ; Prospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; United States - epidemiology</subject><ispartof>Cardiovascular diabetology, 2024-10, Vol.23 (1), p.356</ispartof><rights>2024. The Author(s).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39385258$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carew, A S</creatorcontrib><creatorcontrib>Warren, R A</creatorcontrib><creatorcontrib>Bancks, M P</creatorcontrib><creatorcontrib>Espeland, M A</creatorcontrib><creatorcontrib>Bahnson, J L</creatorcontrib><creatorcontrib>Lewis, C L</creatorcontrib><creatorcontrib>Levy, A P</creatorcontrib><creatorcontrib>Sapp, J L</creatorcontrib><creatorcontrib>Urquhart, R</creatorcontrib><creatorcontrib>Wang, J L</creatorcontrib><creatorcontrib>Rimm, E B</creatorcontrib><creatorcontrib>Cahill, L E</creatorcontrib><title>The relationship between repeated measurements of HbA 1c and risk of coronary events among the common haptoglobin phenotype groups: the Action for Health in Diabetes (Look AHEAD) study</title><title>Cardiovascular diabetology</title><addtitle>Cardiovasc Diabetol</addtitle><description>In the ACCORD study, participants with the haptoglobin (Hp) 2-2 phenotype and glycated hemoglobin (HbA
) ≥ 8.0% had a higher risk of coronary artery disease (CAD) compared to those with HbA
7.0-7.9%. However, this association was not observed in participants without the Hp2-2 phenotype. The optimal glycemic target for CAD prevention for the Hp phenotypes remains uncertain and may vary based on demographic and clinical factors.
To investigate how reaching clinically relevant HbA
targets relates to the risk of CAD in different Hp phenotype groups among a diverse cohort of individuals with T2DM (the Look AHEAD study, HbA
≤ 11% at baseline).
Cox regression models with time-varying covariables were used to quantify the association between time-varying achieved HbA
(< 6.5%, 6.5-6.9%, and ≥ 8.0% compared to 7.0-7.9%), updated at years 1-4, 6, 8, and 10, and incident CAD in the Hp2-2 (n = 1,587) and non-Hp2-2 (n = 2,944) phenotypes separately. Further pre-specified subgroup analyses by age, sex, history of cardiovascular disease (CVD), race, and diabetes duration were performed in each Hp phenotype group separately.
Compared with HbA
7.0-7.9%, having HbA
< 6.5% was associated with a 29% lower CAD risk among participants with the non-Hp2-2 phenotype (adjusted HR 0.71, 95% CI 0.55-0.90). In subgroup analyses, this association was present in participants with the non-Hp2-2 phenotype who were male (0.60, 0.44-0.83), who did not have a history of CVD (0.65, 0.47-0.90), who were aged ≥ 65 years (0.64, 0.44-0.94), who were White (0.68, 0.51-0.91), or who had diabetes duration > 10 years (0.58, 0.35-0.95). HbA
≥ 8.0% was associated with CAD risk only among participants with the Hp2-2 phenotype who had a history of CVD (1.79, 1.00-3.20). No associations were found between the other HbA
targets and CAD risk when participants with the Hp2-2 phenotype were grouped together or divided into subgroups.
The differences in our results compared to our previous findings may be due to variations in the study populations and factors associated with weight loss, making it difficult to draw definitive conclusions. Our current findings should be considered in the context of hypothesis generation, and ideally, will encourage additional research in this field.</description><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - metabolism</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Female</subject><subject>Glycated Hemoglobin - metabolism</subject><subject>Glycemic Control</subject><subject>Haptoglobins - genetics</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Phenotype</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>1475-2840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFj8tOwzAQRS0kRMvjB1igWcIiEOfRpuwiWpQFy-4rJ5k8aOyxbAcUvozPw6lgzWI0o6uj0bmM3fLwkfNs9WR5tInjIIySeZIs-DpjS56s0yDKknDBLq19D0O-zlb8gi3iTZylUZot2fe-QzA4CNeTsl2voUT3iah8qFE4rEGisKNBicpZoAaKMgdegVA1mN4e56giQ0qYCfDjRAlJqgXnX1ck_Q2d0I7agcpege5QkZs0Qmto1Pb5BObVbAANGShQDK4Dj2574XXQwv0b0RHyYpdvH8C6sZ6u2XkjBos3v_uK3b3u9i9FoMdSYn3Qppfe6PBXNf4X-AG_s2eL</recordid><startdate>20241009</startdate><enddate>20241009</enddate><creator>Carew, A S</creator><creator>Warren, R A</creator><creator>Bancks, M P</creator><creator>Espeland, M A</creator><creator>Bahnson, J L</creator><creator>Lewis, C L</creator><creator>Levy, A P</creator><creator>Sapp, J L</creator><creator>Urquhart, R</creator><creator>Wang, J L</creator><creator>Rimm, E B</creator><creator>Cahill, L E</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20241009</creationdate><title>The relationship between repeated measurements of HbA 1c and risk of coronary events among the common haptoglobin phenotype groups: the Action for Health in Diabetes (Look AHEAD) study</title><author>Carew, A S ; Warren, R A ; Bancks, M P ; Espeland, M A ; Bahnson, J L ; Lewis, C L ; Levy, A P ; Sapp, J L ; Urquhart, R ; Wang, J L ; Rimm, E B ; Cahill, L E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-pubmed_primary_393852583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - metabolism</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Female</topic><topic>Glycated Hemoglobin - metabolism</topic><topic>Glycemic Control</topic><topic>Haptoglobins - genetics</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Phenotype</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carew, A S</creatorcontrib><creatorcontrib>Warren, R A</creatorcontrib><creatorcontrib>Bancks, M P</creatorcontrib><creatorcontrib>Espeland, M A</creatorcontrib><creatorcontrib>Bahnson, J L</creatorcontrib><creatorcontrib>Lewis, C L</creatorcontrib><creatorcontrib>Levy, A P</creatorcontrib><creatorcontrib>Sapp, J L</creatorcontrib><creatorcontrib>Urquhart, R</creatorcontrib><creatorcontrib>Wang, J L</creatorcontrib><creatorcontrib>Rimm, E B</creatorcontrib><creatorcontrib>Cahill, L E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Cardiovascular diabetology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carew, A S</au><au>Warren, R A</au><au>Bancks, M P</au><au>Espeland, M A</au><au>Bahnson, J L</au><au>Lewis, C L</au><au>Levy, A P</au><au>Sapp, J L</au><au>Urquhart, R</au><au>Wang, J L</au><au>Rimm, E B</au><au>Cahill, L E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The relationship between repeated measurements of HbA 1c and risk of coronary events among the common haptoglobin phenotype groups: the Action for Health in Diabetes (Look AHEAD) study</atitle><jtitle>Cardiovascular diabetology</jtitle><addtitle>Cardiovasc Diabetol</addtitle><date>2024-10-09</date><risdate>2024</risdate><volume>23</volume><issue>1</issue><spage>356</spage><pages>356-</pages><eissn>1475-2840</eissn><abstract>In the ACCORD study, participants with the haptoglobin (Hp) 2-2 phenotype and glycated hemoglobin (HbA
) ≥ 8.0% had a higher risk of coronary artery disease (CAD) compared to those with HbA
7.0-7.9%. However, this association was not observed in participants without the Hp2-2 phenotype. The optimal glycemic target for CAD prevention for the Hp phenotypes remains uncertain and may vary based on demographic and clinical factors.
To investigate how reaching clinically relevant HbA
targets relates to the risk of CAD in different Hp phenotype groups among a diverse cohort of individuals with T2DM (the Look AHEAD study, HbA
≤ 11% at baseline).
Cox regression models with time-varying covariables were used to quantify the association between time-varying achieved HbA
(< 6.5%, 6.5-6.9%, and ≥ 8.0% compared to 7.0-7.9%), updated at years 1-4, 6, 8, and 10, and incident CAD in the Hp2-2 (n = 1,587) and non-Hp2-2 (n = 2,944) phenotypes separately. Further pre-specified subgroup analyses by age, sex, history of cardiovascular disease (CVD), race, and diabetes duration were performed in each Hp phenotype group separately.
Compared with HbA
7.0-7.9%, having HbA
< 6.5% was associated with a 29% lower CAD risk among participants with the non-Hp2-2 phenotype (adjusted HR 0.71, 95% CI 0.55-0.90). In subgroup analyses, this association was present in participants with the non-Hp2-2 phenotype who were male (0.60, 0.44-0.83), who did not have a history of CVD (0.65, 0.47-0.90), who were aged ≥ 65 years (0.64, 0.44-0.94), who were White (0.68, 0.51-0.91), or who had diabetes duration > 10 years (0.58, 0.35-0.95). HbA
≥ 8.0% was associated with CAD risk only among participants with the Hp2-2 phenotype who had a history of CVD (1.79, 1.00-3.20). No associations were found between the other HbA
targets and CAD risk when participants with the Hp2-2 phenotype were grouped together or divided into subgroups.
The differences in our results compared to our previous findings may be due to variations in the study populations and factors associated with weight loss, making it difficult to draw definitive conclusions. Our current findings should be considered in the context of hypothesis generation, and ideally, will encourage additional research in this field.</abstract><cop>England</cop><pmid>39385258</pmid><doi>10.1186/s12933-024-02448-z</doi></addata></record> |
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| ispartof | Cardiovascular diabetology, 2024-10, Vol.23 (1), p.356 |
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| subjects | Aged Biomarkers - blood Blood Glucose - metabolism Coronary Artery Disease - blood Coronary Artery Disease - diagnosis Coronary Artery Disease - epidemiology Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - epidemiology Female Glycated Hemoglobin - metabolism Glycemic Control Haptoglobins - genetics Humans Hypoglycemic Agents - therapeutic use Incidence Male Middle Aged Phenotype Prospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome United States - epidemiology |
| title | The relationship between repeated measurements of HbA 1c and risk of coronary events among the common haptoglobin phenotype groups: the Action for Health in Diabetes (Look AHEAD) study |
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