ArticleFrontiers in endocrinology2026
Glycemic biomarkers and cardiovascular disease in diabetes: a comparative analysis of population-based and clinical cohorts.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Cardiovascular disease (CVD) remains a major complication contributing to morbidity and mortality among individuals with diabetes. Different glycemic biomarkers reflect distinct aspects of glucose metabolism, but their associations with prevalent CVD across different diabetic populations remain incompletely understood. This study aimed to evaluate the associations of fasting blood glucose (FBG), glycated hemoglobin A1c (HbA1c), and triglyceride-glucose index (TyG) with prevalent CVD among adults with diabetes. Methods: This study included adults with diabetes from two independent cross-sectional cohorts: a population-based cohort derived from the National Health and Nutrition Examination Survey (NHANES) 2005-2020 (n = 3,418) and a Chinese clinical cohort of hospitalized patients with diabetes (n = 765). Multivariable logistic regression models, subgroup analyses, and restricted cubic spline (RCS) analyses were performed to evaluate the associations between glycemic biomarkers and prevalent CVD. Results: After adjustment for potential confounders, HbA1c was consistently associated with prevalent CVD in both cohorts. In the fully adjusted model, each unit increase in HbA1c was associated with higher odds of prevalent CVD in the population-based cohort (OR = 1.097, 95% CI: 1.002-1.202, Conclusion: Among adults with diabetes, HbA1c showed a consistent positive association with prevalent CVD across population-based and clinical cohorts, whereas the associations of FBG and TyG were less consistent. These findings support the relevance of HbA1c as a measure of long-term glycemic status in relation to prevalent CVD among individuals with diabetes. Further longitudinal studies are warranted to clarify the temporal relationship between HbA1c and cardiovascular outcomes.
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