Prediction of Type 2 Diabetes by Hemoglobin A1c in Two Community-Based Cohorts

OBJECTIVEHemoglobin A1c (HbA1c) can be used to assess type 2 diabetes (T2D) risk. We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability: 1) HbA1c alone, 2) fasting laboratory tests, 3) clinic data, and 4) fasting laboratory tests and clinic data.R...

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Veröffentlicht in:Diabetes care 2018-01, Vol.41 (1), p.60-68
Hauptverfasser: Leong, Aaron, Daya, Natalie, Porneala, Bianca, Devlin, James J., Shiffman, Dov, McPhaul, Michael J., Selvin, Elizabeth, Meigs, James B.
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container_end_page 68
container_issue 1
container_start_page 60
container_title Diabetes care
container_volume 41
creator Leong, Aaron
Daya, Natalie
Porneala, Bianca
Devlin, James J.
Shiffman, Dov
McPhaul, Michael J.
Selvin, Elizabeth
Meigs, James B.
description OBJECTIVEHemoglobin A1c (HbA1c) can be used to assess type 2 diabetes (T2D) risk. We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability: 1) HbA1c alone, 2) fasting laboratory tests, 3) clinic data, and 4) fasting laboratory tests and clinic data.RESEARCH DESIGN AND METHODSWe studied a prospective cohort of white (N = 11,244) and black (N = 2,294) middle-aged participants without diabetes in the Framingham Heart Study and Atherosclerosis Risk in Communities study. Association of HbA1c with incident T2D (defined by medication use or fasting glucose [FG] ≥126 mg/dL) was evaluated in regression models adjusted for 1) age and sex (demographics); 2) demographics, FG, HDL, and triglycerides; 3) demographics, BMI, blood pressure, and T2D family history; or 4) all preceding covariates. We combined results from cohort and race analyses by random-effects meta-analyses. Subsidiary analyses tested the association of HbA1c with developing T2D within 8 years or only after 8 years.RESULTSOver 20 years, 3,315 individuals developed T2D. With adjustment for demographics, the odds of T2D increased fourfold for each percentage-unit increase in HbA1c. The odds ratio (OR) was 4.00 (95% CI 3.14, 5.10) for blacks and 4.73 (3.10, 7.21) for whites, resulting in a combined OR of 4.50 (3.35, 6.03). After adjustment for fasting laboratory tests and clinic data, the combined OR was 2.68 (2.15, 3.34) over 20 years, 5.79 (2.51, 13.36) within 8 years, and 2.23 (1.94, 2.57) after 8 years.CONCLUSIONSHbA1c predicts T2D in different common scenarios and is useful for identifying individuals with elevated T2D risk in both the short- and long-term.
doi_str_mv 10.2337/dc17-0607
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We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability: 1) HbA1c alone, 2) fasting laboratory tests, 3) clinic data, and 4) fasting laboratory tests and clinic data.RESEARCH DESIGN AND METHODSWe studied a prospective cohort of white (N = 11,244) and black (N = 2,294) middle-aged participants without diabetes in the Framingham Heart Study and Atherosclerosis Risk in Communities study. Association of HbA1c with incident T2D (defined by medication use or fasting glucose [FG] ≥126 mg/dL) was evaluated in regression models adjusted for 1) age and sex (demographics); 2) demographics, FG, HDL, and triglycerides; 3) demographics, BMI, blood pressure, and T2D family history; or 4) all preceding covariates. We combined results from cohort and race analyses by random-effects meta-analyses. Subsidiary analyses tested the association of HbA1c with developing T2D within 8 years or only after 8 years.RESULTSOver 20 years, 3,315 individuals developed T2D. With adjustment for demographics, the odds of T2D increased fourfold for each percentage-unit increase in HbA1c. The odds ratio (OR) was 4.00 (95% CI 3.14, 5.10) for blacks and 4.73 (3.10, 7.21) for whites, resulting in a combined OR of 4.50 (3.35, 6.03). After adjustment for fasting laboratory tests and clinic data, the combined OR was 2.68 (2.15, 3.34) over 20 years, 5.79 (2.51, 13.36) within 8 years, and 2.23 (1.94, 2.57) after 8 years.CONCLUSIONSHbA1c predicts T2D in different common scenarios and is useful for identifying individuals with elevated T2D risk in both the short- and long-term.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc17-0607</identifier><identifier>PMID: 29074816</identifier><language>eng</language><publisher>American Diabetes Association</publisher><subject>Epidemiology/Health Services Research</subject><ispartof>Diabetes care, 2018-01, Vol.41 (1), p.60-68</ispartof><rights>2017 by the American Diabetes Association. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-594f6b542d774104a382d42f5c6189c107ba424ba6fbbbb6dcfef37546dd98373</citedby><cites>FETCH-LOGICAL-c418t-594f6b542d774104a382d42f5c6189c107ba424ba6fbbbb6dcfef37546dd98373</cites><orcidid>0000-0001-6923-7151 ; 0000-0002-3248-9547 ; 0000-0002-2439-2657</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids></links><search><creatorcontrib>Leong, Aaron</creatorcontrib><creatorcontrib>Daya, Natalie</creatorcontrib><creatorcontrib>Porneala, Bianca</creatorcontrib><creatorcontrib>Devlin, James J.</creatorcontrib><creatorcontrib>Shiffman, Dov</creatorcontrib><creatorcontrib>McPhaul, Michael J.</creatorcontrib><creatorcontrib>Selvin, Elizabeth</creatorcontrib><creatorcontrib>Meigs, James B.</creatorcontrib><title>Prediction of Type 2 Diabetes by Hemoglobin A1c in Two Community-Based Cohorts</title><title>Diabetes care</title><description>OBJECTIVEHemoglobin A1c (HbA1c) can be used to assess type 2 diabetes (T2D) risk. We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability: 1) HbA1c alone, 2) fasting laboratory tests, 3) clinic data, and 4) fasting laboratory tests and clinic data.RESEARCH DESIGN AND METHODSWe studied a prospective cohort of white (N = 11,244) and black (N = 2,294) middle-aged participants without diabetes in the Framingham Heart Study and Atherosclerosis Risk in Communities study. Association of HbA1c with incident T2D (defined by medication use or fasting glucose [FG] ≥126 mg/dL) was evaluated in regression models adjusted for 1) age and sex (demographics); 2) demographics, FG, HDL, and triglycerides; 3) demographics, BMI, blood pressure, and T2D family history; or 4) all preceding covariates. We combined results from cohort and race analyses by random-effects meta-analyses. Subsidiary analyses tested the association of HbA1c with developing T2D within 8 years or only after 8 years.RESULTSOver 20 years, 3,315 individuals developed T2D. With adjustment for demographics, the odds of T2D increased fourfold for each percentage-unit increase in HbA1c. The odds ratio (OR) was 4.00 (95% CI 3.14, 5.10) for blacks and 4.73 (3.10, 7.21) for whites, resulting in a combined OR of 4.50 (3.35, 6.03). After adjustment for fasting laboratory tests and clinic data, the combined OR was 2.68 (2.15, 3.34) over 20 years, 5.79 (2.51, 13.36) within 8 years, and 2.23 (1.94, 2.57) after 8 years.CONCLUSIONSHbA1c predicts T2D in different common scenarios and is useful for identifying individuals with elevated T2D risk in both the short- and long-term.</description><subject>Epidemiology/Health Services Research</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpVkEtPwzAQhC0EoqVw4B_4CIeAHduxc0Eq5VGkCjiUs-X40RolcbETUP89qVohsZfRakczqw-AS4xuckL4rdGYZ6hA_AiMcUlYxhgVx2CMMC0zVpb5CJyl9IkQolSIUzDKS8SpwMUYvL5Ha7zufGhhcHC53ViYwwevKtvZBKstnNsmrOpQ-RZOsYaDLH8CnIWm6VvfbbN7lawZ9nWIXToHJ07VyV4cdAI-nh6Xs3m2eHt-mU0XmaZYdMNP1BUVo7nhnGJEFRG5obljusCi1BjxStGcVqpw1TCF0c46whktjCkF4WQC7va5m75qrNG27aKq5Sb6RsWtDMrL_5fWr-UqfEs29GFGh4CrQ0AMX71NnWx80rauVWtDnyQuB2fBBCGD9Xpv1TGkFK37q8FI7vjLHX-5409-AW9pdks</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Leong, Aaron</creator><creator>Daya, Natalie</creator><creator>Porneala, Bianca</creator><creator>Devlin, James J.</creator><creator>Shiffman, Dov</creator><creator>McPhaul, Michael J.</creator><creator>Selvin, Elizabeth</creator><creator>Meigs, James B.</creator><general>American Diabetes Association</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6923-7151</orcidid><orcidid>https://orcid.org/0000-0002-3248-9547</orcidid><orcidid>https://orcid.org/0000-0002-2439-2657</orcidid></search><sort><creationdate>20180101</creationdate><title>Prediction of Type 2 Diabetes by Hemoglobin A1c in Two Community-Based Cohorts</title><author>Leong, Aaron ; Daya, Natalie ; Porneala, Bianca ; Devlin, James J. ; Shiffman, Dov ; McPhaul, Michael J. ; Selvin, Elizabeth ; Meigs, James B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-594f6b542d774104a382d42f5c6189c107ba424ba6fbbbb6dcfef37546dd98373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Epidemiology/Health Services Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leong, Aaron</creatorcontrib><creatorcontrib>Daya, Natalie</creatorcontrib><creatorcontrib>Porneala, Bianca</creatorcontrib><creatorcontrib>Devlin, James J.</creatorcontrib><creatorcontrib>Shiffman, Dov</creatorcontrib><creatorcontrib>McPhaul, Michael J.</creatorcontrib><creatorcontrib>Selvin, Elizabeth</creatorcontrib><creatorcontrib>Meigs, James B.</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leong, Aaron</au><au>Daya, Natalie</au><au>Porneala, Bianca</au><au>Devlin, James J.</au><au>Shiffman, Dov</au><au>McPhaul, Michael J.</au><au>Selvin, Elizabeth</au><au>Meigs, James B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of Type 2 Diabetes by Hemoglobin A1c in Two Community-Based Cohorts</atitle><jtitle>Diabetes care</jtitle><date>2018-01-01</date><risdate>2018</risdate><volume>41</volume><issue>1</issue><spage>60</spage><epage>68</epage><pages>60-68</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>OBJECTIVEHemoglobin A1c (HbA1c) can be used to assess type 2 diabetes (T2D) risk. We asked whether HbA1c was associated with T2D risk in four scenarios of clinical information availability: 1) HbA1c alone, 2) fasting laboratory tests, 3) clinic data, and 4) fasting laboratory tests and clinic data.RESEARCH DESIGN AND METHODSWe studied a prospective cohort of white (N = 11,244) and black (N = 2,294) middle-aged participants without diabetes in the Framingham Heart Study and Atherosclerosis Risk in Communities study. Association of HbA1c with incident T2D (defined by medication use or fasting glucose [FG] ≥126 mg/dL) was evaluated in regression models adjusted for 1) age and sex (demographics); 2) demographics, FG, HDL, and triglycerides; 3) demographics, BMI, blood pressure, and T2D family history; or 4) all preceding covariates. We combined results from cohort and race analyses by random-effects meta-analyses. Subsidiary analyses tested the association of HbA1c with developing T2D within 8 years or only after 8 years.RESULTSOver 20 years, 3,315 individuals developed T2D. With adjustment for demographics, the odds of T2D increased fourfold for each percentage-unit increase in HbA1c. The odds ratio (OR) was 4.00 (95% CI 3.14, 5.10) for blacks and 4.73 (3.10, 7.21) for whites, resulting in a combined OR of 4.50 (3.35, 6.03). After adjustment for fasting laboratory tests and clinic data, the combined OR was 2.68 (2.15, 3.34) over 20 years, 5.79 (2.51, 13.36) within 8 years, and 2.23 (1.94, 2.57) after 8 years.CONCLUSIONSHbA1c predicts T2D in different common scenarios and is useful for identifying individuals with elevated T2D risk in both the short- and long-term.</abstract><pub>American Diabetes Association</pub><pmid>29074816</pmid><doi>10.2337/dc17-0607</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6923-7151</orcidid><orcidid>https://orcid.org/0000-0002-3248-9547</orcidid><orcidid>https://orcid.org/0000-0002-2439-2657</orcidid><oa>free_for_read</oa></addata></record>
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title Prediction of Type 2 Diabetes by Hemoglobin A1c in Two Community-Based Cohorts
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