Increased Estimated 10-Year Risk for Cardiovascular Disease Assessed Using the Pooled Cohort Equation in Non-Diabetic Subjects According to Increasing HbA1c Levels

Abstract

Objective: In 2013, a new risk calculator known as the Pooled Cohort Equation (PCE) was introduced with the new cholesterol guideline. We aimed to calculate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk using PCE in non-diabetic Korean subjects with glycated hemoglobin (HbA1c) lower than 6.5%. Methods: A total of 17,519 participants were evaluated in a health screening program. The 10-year ASCVD risk was calculated using the PCE. Subjects with underlying diabetes or HbA1c ≥6.5% were excluded. Subjects were divided into four groups according to fasting blood glucose (FBG) and HbA1c levels: FBG 120 mg/dL in the four divided groups (2.6%, 3.3%, 3.8%, 4.1%; p 5.8% (2.4%, 2.7%, 3.0%, 3.6%; p<0.01). The odds ratio for 10-year ASCVD risk ≥10% significantly increased from group I to IV according to FBG and HbA1c levels after adjusting for age, body mass index and fasting insulin level (1.187, 1.753, and 2.390 vs. 1.0 in the lowest FBG group; 1.626, 1.574, and 1.645 vs. 1.0 in the lowest HbA1c group). Conclusion: The 10-year ASCVD risk calculated using the PCE significantly increased as the FBG and HbA1c increased even in Korean subjects without underlying diabetes.