Distribution of glycosylated hemoglobin and association with coronary heart disease in non-diabetic individuals

Abstract

Objective To analyze the relation between glycosylated hemoglobin (HbA1c) and coronary heart disease (CHD) among diabetic and non-diabetic individuals. Methods A total of 1190 in patients from January 2009 to September 2009 were selected and divided into two groups:225 patients with diabete mellitus and 965 patients without.We collected the age，sex，triglyceride (TG)，total cholesterol (CHO)，high-density lipoprotein (HDL-C)，low-density lipoprotein (LDL-C)，fasting blood-glucose (FBG)，glycosylated hemoglobin (HbA1c)，high-sensitivity CRP (hs-CRP) and analyzed the relation between these indexes and CHD in diabetic and non-diabetic individuals respectively, then, analyzed the difference of HbA1c between patients with and without CHD after correcting the differentiating factor with a multivariable-adjusted model.Meanwhile, according the HbA1c level, we divided all participants into four groups:4.0%-5.4%（Ⅰ），5.5%-5.9%（Ⅱ），6.0%-6.4%（Ⅲ），≥6.5%（Ⅳ），and observed the distribution of HbA1c and coronary heart disease in diabetic and non-diabetic individuals respectively. Results (1) In non-diabetic individuals, statistically significant difference of male（80.5% vs 62.7%）, age ［(59±11) years vs (55±11) years］, FBG ［(5.62±1.48) mmol/L vs (5.30±0.84) mmol/L］, HbA1c［(5.98±0.92)% vs (5.65±0.53)%］, CHO ［(4.48±1.01) mmol/L vs (4.77±1.04) mmol/L］, LDL-C ［(2.59±0.87) mmol/L vs (2.79±0.86) mmol/L］, HDL-C ［(1.08±0.26) mmol/L vs (1.21±0.32) mmol/L］ was observed between patients with and without CHD (P<0.01), however, in diabetic individuals, only LDL-C ［(2.56±0.81) mmol/L vs (3.07±0.90) mmol/L］, CHO ［(4.44±0.95) mmol/L vs (5.08±1.16) mmol/L］ were observed (P<0.01).(2) In all participants, the higher of HbA1c, the higher of CHD percent, compared to patients without CHD, the percent of high HbA1c in CHD patients was significantly higher.After adjusting for age，sex，HDL-C, HbA1c was an independent risk marker for CHD in non-diabetic individuals（OR：1.935,95%CI：1.356-2.762，P<0.05）,however, links between FBG in the non-diabetic range and CHD appeared weaker after controlling indexes listed above（OR：1.507，95%CI：1.082-2.098，P<0.05）. Conclusion HbA1c is an independent risk factor for CHD in non-diabetic individuals and prior to FBG.（Chin J Lab Med，2012,35：521-525） Key words: Hemoglobin A glycosylated; Coronary disease; Risk factors