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Hemoglobin A1c and arterial and ventricular stiffness in older adults.
Monday,2013-04-22 14:57 America/Los_Angeles — eenright
| Title | Hemoglobin A1c and arterial and ventricular stiffness in older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2012 |
| Authors | Zieman, SJ, Kamineni, A, Ix, JH, Barzilay, J, Djoussé, L, Kizer, JR, Biggs, ML, de Boer, IH, Chonchol, M, Gottdiener, JS, Selvin, E, Newman, AB, Kuller, LH, Siscovick, DS, Mukamal, KJ |
| Journal | PLoS One |
| Volume | 7 |
| Issue | 10 |
| Pagination | e47941 |
| Date Published | 2012 |
| ISSN | 1932-6203 |
| Keywords | Adult, African Continental Ancestry Group, Aged, Ankle Brachial Index, Arteries, Blood Glucose, Blood Pressure, Body Mass Index, Cross-Sectional Studies, Fasting, Female, Genetic Association Studies, Glycated Hemoglobin A, Glycation End Products, Advanced, Heart Ventricles, Humans, Male, Middle Aged, Ultrasonography, Vascular Stiffness |
| Abstract | <p><b>OBJECTIVE: </b>Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE) are implicated in this stiffening pathophysiology. We examined the association between HbA(1c), an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes.</p><p><b>RESEARCH DESIGN & METHODS: </b>Baseline HbA(1c) was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥ 65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA(1c) and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG) with like measures.</p><p><b>RESULTS: </b>HbA(1c) was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both) and positively associated with greater body-mass index and black race. In adjusted models, HbA(1c) was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP), carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM). FG levels were positively associated with systolic, diastolic and PP and LVM.</p><p><b>CONCLUSIONS: </b>In this sample of older adults without diabetes, HbA(1c) was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.</p> |
| DOI | 10.1371/journal.pone.0047941 |
| Alternate Journal | PLoS ONE |
| PubMed ID | 23118911 |
| PubMed Central ID | PMC3484154 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States R01HL094555 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01 HC-15103 / HC / NHLBI NIH HHS / United States K01DK076595 / DK / NIDDK NIH HHS / United States N01-HC-45133 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States |