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Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes.

Publication ,  Journal Article
Selvin, E; Ning, Y; Steffes, MW; Bash, LD; Klein, R; Wong, TY; Astor, BC; Sharrett, AR; Brancati, FL; Coresh, J
Published in: Diabetes
January 2011

OBJECTIVE: Glycated hemoglobin was recently recommended for use as a diagnostic test for diabetes. We examined the association between 2010 American Diabetes Association diagnostic cut points for glycated hemoglobin and microvascular outcomes (chronic kidney disease, end-stage renal disease [ESRD], and retinopathy) and formally tested for the presence of risk thresholds in the relationships of glycated hemoglobin with these outcomes. RESEARCH DESIGN AND METHODS: Prospective cohort and cross-sectional analyses of 11,357 participants (773 with a history of diagnosed diabetes) from the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS: During a median of 14 years of follow-up of individuals without diagnosed diabetes at baseline, clinical categories of glycated hemoglobin were associated with risk of chronic kidney disease, with adjusted hazard ratios (HRs) of 1.12 (0.94-1.34) and 1.39 (1.04-1.85) for glycated hemoglobin 5.7-6.4% and ≥6.5%, respectively, as compared with <5.7% (P trend = 0.002). The corresponding HRs for ESRD were 1.51 (0.82-2.76) and 1.98 (0.83-4.73), respectively (P trend = 0.047). In the absence of diagnosed diabetes, glycated hemoglobin was cross sectionally associated with the presence of moderate/severe retinopathy, with adjusted odds ratios of 1.42 (0.69-2.92) and 2.91 (1.19-7.11) for glycated hemoglobin 5.7-<6.5% and ≥6.5%, respectively, compared with <5.7% (P trend = 0.011). Risk associations were stronger among individuals with a history of diabetes. We did not observe significant thresholds in the associations of glycated hemoglobin with kidney disease risk or retinopathy. CONCLUSIONS: These data from a community-based, biracial population support the use of new 2010 American Diabetes Association glycated hemoglobin cut points for the diagnosis of diabetes.

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Published In

Diabetes

DOI

EISSN

1939-327X

Publication Date

January 2011

Volume

60

Issue

1

Start / End Page

298 / 305

Location

United States

Related Subject Headings

  • Triglycerides
  • Smoking
  • Risk Factors
  • Retinal Diseases
  • Racial Groups
  • Prospective Studies
  • Prevalence
  • Odds Ratio
  • Male
  • Life Style
 

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Chicago
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Selvin, E., Ning, Y., Steffes, M. W., Bash, L. D., Klein, R., Wong, T. Y., … Coresh, J. (2011). Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes. Diabetes, 60(1), 298–305. https://doi.org/10.2337/db10-1198
Selvin, Elizabeth, Yang Ning, Michael W. Steffes, Lori D. Bash, Ronald Klein, Tien Y. Wong, Brad C. Astor, A Richey Sharrett, Frederick L. Brancati, and Josef Coresh. “Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes.Diabetes 60, no. 1 (January 2011): 298–305. https://doi.org/10.2337/db10-1198.
Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY, et al. Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes. Diabetes. 2011 Jan;60(1):298–305.
Selvin, Elizabeth, et al. “Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes.Diabetes, vol. 60, no. 1, Jan. 2011, pp. 298–305. Pubmed, doi:10.2337/db10-1198.
Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY, Astor BC, Sharrett AR, Brancati FL, Coresh J. Glycated hemoglobin and the risk of kidney disease and retinopathy in adults with and without diabetes. Diabetes. 2011 Jan;60(1):298–305.

Published In

Diabetes

DOI

EISSN

1939-327X

Publication Date

January 2011

Volume

60

Issue

1

Start / End Page

298 / 305

Location

United States

Related Subject Headings

  • Triglycerides
  • Smoking
  • Risk Factors
  • Retinal Diseases
  • Racial Groups
  • Prospective Studies
  • Prevalence
  • Odds Ratio
  • Male
  • Life Style