Though blood glucose and glycated hemoglobin (HbA1c) perform a central function in diabetes, the worth of these measurements to assess cardiovascular threat has been unclear. Now, in a paper published in JAMA, members of the Emerging Danger Elements Collaboration analyze data from nearly 300,000 individuals with no acknowledged diabetes or cardiovascular condition who were enrolled in 73 prospective research.
The authors identified that incorporating glycemia measures to standard cardiovascular threat evaluation presented little additional prognostic info. More, including info about blood glucose did not outcome in a substantial improvement in the classification of individuals used to help make a decision about preventive remedy.
1 relatively surprising locating was that 4 diverse measures of glycemia independently resulted in a J-shaped curve of cardiovascular chance — even though reduce glycemia amounts were usually connected with lower ranges of danger, at the excessive lowest degree there was a rebound in risk. This finding “should encourage further scientific studies to check regardless of whether quite low glycemia ranges are markers of ill overall health,” compose the authors.
Yet another nonintuitive discovering was that HbA1c measures were “at least equal” to fasting, random, and postload plasma glucose levels in assessing risk. “This obtaining challenges recommendations that postload glucose ranges predict CVD incidence much more strongly than do other glycemia measures,” they say.
The authors conclude: “Contrary to suggestions in some guidelines, the current examination of individual-participant data in practically 300,000 people with out recognized diabetes and CVD at baseline indicates that measurement of HbA1c is not associated with clinically meaningful improvement in evaluation of CVD threat.”