Why the study?
Are elevated HbA1c and systolic blood pressure associated with increased carotid atherosclerosis in nondiabetic patients?
Are elevated HbA1c and systolic blood pressure associated with increased carotid atherosclerosis in nondiabetic patients?
Even slight increases in HbA1c, especially when combined with elevated systolic blood pressure, are associated with increased carotid atherosclerosis in nondiabetic patients.
May support HbA1c monitoring in nondiabetic vascular risk assessment; hypothesis-generating for prospective glycemic intervention trials.
Background The relationship between HbA1c, blood pressure, and carotid atherosclerosis in nondiabetic patients is not clear. Hypothesis HbA1c and blood pressure can affect carotid‐artery atherosclerosis in nondiabetic patients. Methods This retrospective cross‐sectional study included 216 patients without diabetes mellitus. A positive carotid ultrasonographic result was defined as intima‐media thickness of the common carotid artery ≥ 0.9 mm, or presence of carotid plaque. Results Compared with patients without carotid atherosclerosis, patients with carotid atherosclerosis had significantly higher levels of HbA1c and systolic blood pressure (SBP). Higher levels of HbA1c and SBP were found to be associated with increased carotid atherosclerosis. Given similar SBP levels, higher HbA1c (>5.6%) was also related to increased carotid atherosclerosis. In multiple logistic regression analysis, HbA1c (odds ratio: 4.1, P = 0.009) emerged as the only statistically significant modifiable factor that was associated with carotid atherosclerosis, independent of smoking, body mass index, fasting plasma glucose, 2‐hour plasma glucose, SBP, diastolic blood pressure, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol. Conclusions Our study shows that a slight increase of HbA1c may associate with carotid atherosclerosis in nondiabetic patients. Moreover, the coexistence of an elevated SBP level and a slightly increased HbA1c level may have a more significant effect on carotid atherosclerosis. Copyright © 2010 Wiley Periodicals, Inc. Dr. Zhu and Dr. Sun contributed equally to this work. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology (Coats AJ. Ethical authorship and publishing. Int J Cardiol. 2009;131:149–150). This work was supported by a Chinese National Science Grant to Dr. Yong Li (Grant No. 30873350). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
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Zhu et al. (2010) studied this question.
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