PLOS ONE | DOI:10.1371/journal.pone.0171761

 

Association between HbA1c and carotid atherosclerosis

among elderly Koreans with normal fasting glucose

Seung Won Lee, Hyeon Chang Kim*, Yong-ho Lee, Bo Mi Song, Hansol Choi, Ji Hye Park, Yumie Rhee, Chang Oh Kim*

 

Abstract

Aim
We examined whether glycated haemoglobin (HbA1c) is associated to carotid atherosclerosis
in an elderly Korean population with normal fasting glucose.

Methods
Using data from the Korean Urban Rural Elderly study, we conducted a cross-sectional analysis of 1,133 participants (335 men and 798 women) with a mean age of 71.8 years. All participants had fasting blood glucose less than 100mg/dL (5.6 mmol/L) and HbA1c level below 6.5% (48 mmol/mol). They were also free from a history of cardiovascular disease, known type 2 diabetes mellitus or use of anti-diabetes medications. Carotid atherosclerosis was assessed by intima-media thickness (IMT) using ultrasonography. The association
between HbA1c and carotid IMT was investigated using multivariable linear regression analysis.

Results
HbA1c levels were independently and positively associated with carotid IMT (β = 0.020, p = 0.045) after adjusting for sex, age, body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, LDL cholesterol, smoking and alcohol intake. However, fasting insulin and glucose levels were not associated with carotid IMT.

Conclusion
HbA1c levels were positively associated with carotid atherosclerosis, as assessed by carotid IMT, in an elderly population with normoglycemia. Our study suggested that higher HbA1c level is an effective and informative marker of carotid atherosclerosis in an elderly population.