Glycated Hemoglobin and All-Cause and Cause-Specific Mortality Among Adults With and Without Diabetes.

Published

Journal Article

CONTEXT: The patterns of associations between glycated Hb (HbA1c) and mortality are still unclear. OBJECTIVE: To explore the extent to which ranges of HbA1c levels are associated with the risk of mortality among participants with and without diabetes. DESIGN, SETTING, AND PATIENTS: This was a nationwide, community-based prospective cohort study. Included were 15,869 participants (median age 64 years) of the Health and Retirement Study, with available HbA1c data and without a history of cancer. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for mortality. RESULTS: A total of 2133 participants died during a median follow-up of 5.8 years. In participants with diabetes, those with an HbA1c level of 6.5% were at the lowest risk of all-cause mortality. When HbA1c level was <5.6% or >7.4%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 6.5%. As for participants without diabetes, those with an HbA1c level of 5.4% were at the lowest risk of all-cause mortality. When the HbA1c level was <5.0%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 5.4%. However, we did not observe a statistically significant elevated risk of all-cause mortality above an HbA1c level of 5.4%. CONCLUSIONS: A U-shaped and reverse J-shaped association for all-cause mortality was found among participants with and without diabetes. The corresponding optimal ranges for overall survival are predicted to be 5.6% and 7.4% and 5.0% and 6.5%, respectively.

Full Text

Duke Authors

Cited Authors

  • Li, F-R; Zhang, X-R; Zhong, W-F; Li, Z-H; Gao, X; Kraus, VB; Lv, Y-B; Zou, M-C; Chen, G-C; Chen, P-L; Zhang, M-Y; Kur, AKA; Shi, X-M; Wu, X-B; Mao, C

Published Date

  • August 1, 2019

Published In

Volume / Issue

  • 104 / 8

Start / End Page

  • 3345 - 3354

PubMed ID

  • 30896760

Pubmed Central ID

  • 30896760

Electronic International Standard Serial Number (EISSN)

  • 1945-7197

Digital Object Identifier (DOI)

  • 10.1210/jc.2018-02536

Language

  • eng

Conference Location

  • United States