ArticleDiabetologia2013
Change in HbA1c over 3 years does not improve the prediction of cardiovascular disease over and above HbA1c measured at a single time point.
Article in Diabetologia, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Strategies to address diabetic kidney disease burden in Mexico: a narrative review by the Mexican College of Nephrologists.Frontiers in medicine · 2024Review
- Associations of mid-pregnancy HbA1c with gestational diabetes and risk of adverse pregnancy outcomes in high-risk Taiwanese women.PloS one · 2017Article
- Oxidative stress and triglycerides as predictors of subclinical atherosclerosis in prediabetes.Redox report : communications in free radical research · 2014Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
aims/hypothesisHbA1c is an important risk factor for cardiovascular disease (CVD), with 1% higher HbA1c levels associated with a 10-20% increased risk of CVD. Little is known about the association between change in HbA1c over time and cardiovascular risk in non-diabetic populations. This study examined the association between change in HbA1c over time and cardiovascular risk in a non-diabetic British population.
methodsWe used data on HbA1c collected at baseline and at a second health examination 3 years later among a population of 5,790 non-diabetic men and women who participated in the European Prospective Investigation of Cancer (EPIC)-Norfolk. The association between change in HbA1c over 3 years and incident cardiovascular events over the following 8 years was examined using multivariate Cox regression. We also examined whether information on change in HbA1c over time improved prediction of cardiovascular events over a single measure of HbA1c by comparing the area under the receiver operating characteristic curves (aROC) and computing the net reclassification improvement.
resultsThe mean change (SD) in HbA1c over 3 years was 0.13% (0.52). During 44,596 person-years of follow-up, 529 cardiovascular events occurred (incidence 11.9 per 1,000 person-years). Each 0.5% rise in HbA1c over 3 years was associated with a 9% increase in risk of a cardiovascular event (HR 1.09; 95% CI 1.01, 1.18) after adjustment for baseline HbA1c and other major cardiovascular risk factors. However, change in HbA1c was not associated with cardiovascular risk after adjustment for HbA1c at follow-up. Multivariate models with and without information on change in HbA1c over time showed a similar aROC of 0.78. Adding change in HbA1c to the model with HbA1c at follow-up did not improve risk classification. CONCLUSIONS/
interpretationAddition of information on change in HbA1c over 3 years did not improve the prediction of CVD over and above information on HbA1c and other major cardiovascular risk factors from a single time point.
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