|Title||Glycated hemoglobin and all-cause and cause-specific mortality among adults with and without diabetes.|
|Publication Type||Journal Article|
|Year of Publication||Forthcoming|
|Authors||Li, F-R, Zhang, X-R, Zhong, W-F, Li, Z-H, Gao, X, Kraus, VByers, Bin Lv, Y-, Zou, M-C, Chen, G-C, Chen, P-L, Zhang, M-Y, Kur, AKuol Akech, Shi, X-M, Wu, X-B, Mao, C|
|Journal||Journal of Clinical Endocrinology and Metabolism|
|Keywords||Biomarkers, Diabetes, Mortality|
CONTEXT: The patterns of associations between glycated hemoglobin (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 (HRs) with 95% confidential intervals (95% CIs) for mortality.
RESULTS: A total of 2,133 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 lower than 5.6% or higher than 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 HbA1c level was lower than 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 a reverse J-shaped association for all-cause mortality were found among participants with and without diabetes. The corresponding Optimal ranges for overall survival are predicted to be 5.6-7.4% and 5.0-6.5%, respectively.
|User Guide Notes|
|Alternate Journal||J. Clin. Endocrinol. Metab.|