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Longitudinal HbA1c trajectory modelling reveals the association of HbA1c and risk of hospitalization for heart failure for patients with type 2 diabetes mellitus.

Publication ,  Journal Article
Tee, C; Xu, H; Fu, X; Cui, D; Jafar, TH; Bee, YM
Published in: PloS one
January 2023

Inconsistent conclusions in past studies on the association between poor glycaemic control and the risk of hospitalization for heart failure (HHF) have been reported largely due to the analysis of non-trajectory-based HbA1c values. Trajectory analysis can incorporate the effects of HbA1c variability across time, which may better elucidate its association with macrovascular complications. Furthermore, studies analysing the relationship between HbA1c trajectories from diabetes diagnosis and the occurrence of HHF are scarce.This is a prospective cohort study of the SingHealth Diabetes Registry (SDR). 17,389 patients diagnosed with type 2 diabetes mellitus (T2DM) from 2013 to 2016 with clinical records extending to the end of 2019 were included in the latent class growth analysis to extract longitudinal HbA1c trajectories. Association between HbA1c trajectories and risk of first known HHF is quantified with the Cox Proportional Hazards (PH) model.5 distinct HbA1c trajectories were identified as 1. low stable (36.1%), 2. elevated stable (40.4%), 3. high decreasing (3.5%), 4. high with a sharp decline (10.8%), and 5. moderate decreasing (9.2%) over the study period of 7 years. Poorly controlled HbA1c trajectories (Classes 3, 4, and 5) are associated with a higher risk of HHF. Using the diabetes diagnosis time instead of a commonly used pre-defined study start time or time from recruitment has an impact on HbA1c clustering results.Findings suggest that tracking the evolution of HbA1c with time has its importance in assessing the HHF risk of T2DM patients, and T2DM diagnosis time as a baseline is strongly recommended in HbA1c trajectory modelling. To the authors' knowledge, this is the first study to identify an association between HbA1c trajectories and HHF occurrence from diabetes diagnosis time.

Duke Scholars

Published In

PloS one

DOI

EISSN

1932-6203

ISSN

1932-6203

Publication Date

January 2023

Volume

18

Issue

1

Start / End Page

e0275610

Related Subject Headings

  • Risk Factors
  • Prospective Studies
  • Humans
  • Hospitalization
  • Heart Failure
  • Glycated Hemoglobin
  • General Science & Technology
  • Diabetes Mellitus, Type 2
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tee, C., Xu, H., Fu, X., Cui, D., Jafar, T. H., & Bee, Y. M. (2023). Longitudinal HbA1c trajectory modelling reveals the association of HbA1c and risk of hospitalization for heart failure for patients with type 2 diabetes mellitus. PloS One, 18(1), e0275610. https://doi.org/10.1371/journal.pone.0275610
Tee, Clarence, Haiyan Xu, Xiuju Fu, Di Cui, Tazeen H. Jafar, and Yong Mong Bee. “Longitudinal HbA1c trajectory modelling reveals the association of HbA1c and risk of hospitalization for heart failure for patients with type 2 diabetes mellitus.PloS One 18, no. 1 (January 2023): e0275610. https://doi.org/10.1371/journal.pone.0275610.
Tee, Clarence, et al. “Longitudinal HbA1c trajectory modelling reveals the association of HbA1c and risk of hospitalization for heart failure for patients with type 2 diabetes mellitus.PloS One, vol. 18, no. 1, Jan. 2023, p. e0275610. Epmc, doi:10.1371/journal.pone.0275610.

Published In

PloS one

DOI

EISSN

1932-6203

ISSN

1932-6203

Publication Date

January 2023

Volume

18

Issue

1

Start / End Page

e0275610

Related Subject Headings

  • Risk Factors
  • Prospective Studies
  • Humans
  • Hospitalization
  • Heart Failure
  • Glycated Hemoglobin
  • General Science & Technology
  • Diabetes Mellitus, Type 2