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Low Hba1c

Hba1c Levels In Non-diabetic Older Adults – No J-shaped Associations With Primary Cardiovascular Events, Cardiovascular And All-cause Mortality After Adjustment For Confounders In A Meta-analysis Of Individual Participant Data From Six Cohort Studies

Hba1c Levels In Non-diabetic Older Adults – No J-shaped Associations With Primary Cardiovascular Events, Cardiovascular And All-cause Mortality After Adjustment For Confounders In A Meta-analysis Of Individual Participant Data From Six Cohort Studies

Abstract To determine the shape of the associations of HbA1c with mortality and cardiovascular outcomes in non-diabetic individuals and explore potential explanations. The associations of HbA1c with all-cause mortality, cardiovascular mortality and primary cardiovascular events (myocardial infarction or stroke) were assessed in non-diabetic subjects ≥50 years from six population-based cohort studies from Europe and the USA and meta-analyzed. Very low, low, intermediate and increased HbA1c were defined as <5.0, 5.0 to <5.5, 5.5 to <6.0 and 6.0 to <6.5 % (equals <31, 31 to <37, 37 to <42 and 42 to <48 mmol/mol), respectively, and low HbA1c was used as reference in Cox proportional hazards models. Overall, 6,769 of 28,681 study participants died during a mean follow-up of 10.7 years, of whom 2,648 died of cardiovascular disease. Furthermore, 2,493 experienced a primary cardiovascular event. A linear association with primary cardiovascular events was observed. Adjustment for cardiovascular risk factors explained about 50 % of the excess risk and attenuated hazard ratios (95 % confidence interval) for increased HbA1c to 1.14 (1.03–1.27), 1.17 (1.00–1.37) and 1.19 (1.04–1.37) for all-cause mortality, cardiovascular mortality and cardiovascular events, respectively. The six cohorts yielded inconsistent results for the association of very low HbA1c levels with the mortality outcomes and the pooled effect estimates were not statistically significant. In one cohort with a pronounced J-shaped association of HbA1c levels with all-cause and cardiovascular mortality (NHANES), the following confounders of the association of very low HbA1c levels with mortality outcomes were identified: race/ethnicity; alcohol consumption; BMI; as well as biomarkers of iron deficiency anemia an Continue reading >>

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c Test (hba1c)

Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin (a blood pigment that carries oxygen) that is bound to glucose. The blood test for HbA1c level is routinely performed in people with type 1 and type 2 diabetes mellitus. Blood HbA1c levels are reflective of how well diabetes is controlled. The normal range for level for hemoglobin A1c is less than 6%. HbA1c also is known as glycosylated, or glycated hemoglobin. HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose. High HbA1c levels indicate poorer control of diabetes than levels in the normal range. HbA1c is typically measured to determine how well a type 1 or type 2 diabetes treatment plan (including medications, exercise, or dietary changes) is working. How Is Hemoglobin A1c Measured? The test for hemoglobin A1c depends on the chemical (electrical) charge on the molecule of HbA1c, which differs from the charges on the other components of hemoglobin. The molecule of HbA1c also differs in size from the other components. HbA1c may be separated by charge and size from the other hemoglobin A components in blood by a procedure called high pressure (or performance) liquid chromatography (HPLC). HPLC separates mixtures (for example, blood) into its various components by adding the mixtures to special liquids and passing them under pressure through columns filled with a material that separates the mixture into its different component molecules. HbA1c testing is done on a blood sample. Because HbA1c is not affected by short-term fluctuations in blood glucose concentrations, for example, due to meals, blood can be drawn for HbA1c testing without regard to when food was eaten. Fasting for the blood test is not necessary. What Are Continue reading >>

Low Hemoglobin A1c And Risk Of All-cause Mortality Among Us Adults Without Diabetes

Low Hemoglobin A1c And Risk Of All-cause Mortality Among Us Adults Without Diabetes

Go to: Abstract Among individuals without diabetes, elevated hemoglobin A1c (HbA1c) has been associated with increased morbidity and mortality, but the literature is sparse regarding the prognostic importance of low HbA1c. Methods and Results National Health and Nutrition Examination Survey III (NHANES III) participants, 20 years and older, were followed up to 12 years (median follow-up, 8.8 years) for all-cause mortality. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association between HbA1c levels and all-cause mortality for 14 099 participants without diabetes. There were 1825 deaths during the follow-up period. Participants with a low HbA1c (<4.0%) had the highest levels of mean red blood cell volume, ferritin, and liver enzymes and the lowest levels of mean total cholesterol and diastolic blood pressure compared with their counterparts with HbA1c levels between 4.0% and 6.4%. An HbA1c <4.0% versus 5.0% to 5.4% was associated with an increased risk of all-cause mortality (HR, 3.73; 95% CI, 1.45 to 9.63) after adjustment for age, race-ethnicity, and sex. This association was attenuated but remained statistically significant after further multivariable adjustment for lifestyle, cardiovascular factors, metabolic factors, red blood cell indices, iron storage indices, and liver function indices (HR, 2.90; 95% CI, 1.25 to 6.76). In this nationally representative cohort, low HbA1c was associated with increased all-cause mortality among US adults without diabetes. Additional research is needed to confirm these results and identify potential mechanisms that may be underlying this association. Keywords: hemoglobin A1c, epidemiology, mortality Continue reading >>

Abnormally Low Hba1c In Type 2 Diabetes Mellitus (t2dm): Familiar Study

Abnormally Low Hba1c In Type 2 Diabetes Mellitus (t2dm): Familiar Study

Abnormally Low HbA1c in Type 2 Diabetes Mellitus (T2DM): Familiar Study HbA1c is the main tool in the HbA1c is the main tool in the follow-up of diabetic patients. So it[apos]s very important to know in which circumstances HbA1c usefulness may be affected. We described the study of a familiar abnormally low HbA1c. [br]Index case was a 35 years old woman who started with T2DM symptoms. A biochemical analysis showed: Glucose 426 mg/dl and HbA1c 10.9 % (TINIA assay [ndash] turbidimetric immunoinhibition -, Normal Value [NV]: 4.5[ndash]6). After 3 months of treatment, an evaluation in our hospital revealed: HbA1c 4.1 % (HPLC assay, NV: 4.5[ndash]5.5), without hypoglycaemic episodes, HbgF 2,4 % (NV [lt]0.5) and normal haematology. A familiar study was undertaken: Mother: HbA1c 2.3 %, HbF 2.2 %. Father: HbA1c 4.8 %, Daughter: HbA1c 2.3 %, HbF 2.1 %; all of them without relevant history and normal blood exam.[br]In the low HbA1c cases a quantification of HbA2 (chromatography), HbF (Alkaline denaturalisation technique) and Hb electrophoresis were performed. Also a molecular analysis was done with the sequence of the products of amplification for PCR of the [beta] globin gene by automatic sequencing with the ABI Prism TM dRhodamine Terminator Cycle Squencing Ready reaction Kit (PE Applied Biosystems, Foster City, AC). All of them showed normal values of HbA2, and HbF. The electrophoretic study exhibited a band at pH 8,2 corresponding to HbA and HbA2, and other atypical band anodal to HbA (Hb J feature); at pH 6 a band corresponding to HbA was observed. The molecular study demonstrated the mutation GGC[rarr]GAC in the codon 16 in heterozygote state (variant known as J-Baltimore [beta 16(A13) Gly[gt]Asp]).[br]We conclude: In the presence of an abnormally low HbA1c by HPLC an elect Continue reading >>

Hba1c Test Results Don't Tell The Full Story

Hba1c Test Results Don't Tell The Full Story

back to Overview When I was a teenager, the HbA1c test results cut straight through my lies and made-up paper logbook. It’s often viewed as the number to rule all numbers. But hemoglobin A1c (HbA1c) test results can be misleading and don’t tell the full story. As I learned in my teens, the HbA1c test shines a light on things I was trying to hide. Overall, It’s not good at getting to the details of blood sugars, but when used with other pieces of information it can draw attention to (sometimes unseen) problem areas in our diabetes management, and that’s a good thing. How do HbA1c test results work? Let’s take a quick look at the basics of the HbA1c test. A certain amount of sugar in your blood sticks to your red blood cells and can’t be unstuck. It’s there for the life of the cell, which is, on average, about 8-12 weeks. Those red blood cells in your body are constantly recycled, and by checking your HbA1c value every 8-12 weeks (or as often as recommended by your doctor – the ADA recommends at least twice a year), you get to see a fresh new grouping of them. So – A higher blood sugar for a longer time means more sugar on more cells – which means a higher HbA1c. Get it? Ideal HbA1c range HbA1c goals are very individual, which makes sense. We’re all different, right? Of course, there are reference values as a guide, and that’s a good place to start. The ADA suggests an HbA1c of 7%, but also say that “more or less stringent glycemic goals may be appropriate for each individual.” Why have different goals? Because, as you know, there’s a lot to consider with diabetes. Avoiding lows (hypoglycemia) while pushing for lower A1c’s is really important because low blood sugars are immediately dangerous. It’s simply not safe to push for a very low H Continue reading >>

Low Hba1c Levels In A Poorly Controlled Diabetic | Postgraduate Medical Journal

Low Hba1c Levels In A Poorly Controlled Diabetic | Postgraduate Medical Journal

Low HbA1c levels in a poorly controlled diabetic Low HbA1c levels in a poorly controlled diabetic The data demonstrate inappropriately low HbA1c values in a subject with symptomatic hyperglycaemia (weight loss, osmotic symptoms, and high plasma glucose values) and abundant glycosuria. Q2: What is the differential diagnosis and what would you do next? If a laboratory error can be ruled out (repeated samples need to be obtained), the main differential diagnosis is of an abnormal haemoglobin variant. Some causes of abnormal HbA1c values are listed in box 1. The next step is to perform haemoglobin electrophoresis. The following results were obtained in this patient: Non-diabetic hyperglycaemia: acromegaly, phaechromocytoma, thyrotoxicosis, Cushings syndrome. Haemolytic anaemia: congenital (for example, spherocytosis and elliptocytosis), haemoglobinopathies, acquired haemolytic anaemiasfor example, drug induced (dapsone, methyldopa). Alkali/acid elution: haemoglobin A + J (confirms the presence of abnormal haemoglobin J). Globin: fast beta chain variant (abnormal beta chain). Abnormal haemoglobin: 48% (a high percentage of haemoglobin J) Sickledex: negative (no evidence of sickle cells). These tests are consistent with a diagnosis of haemoglobin beta chain variant: J trait. Q3: What is the pathophysiological basis of the discrepancies observed and how would you assess this mans long term glycaemic control? Non-enzymatic binding of glucose to the valine residue of the beta chain of the haemoglobin molecule gives rise to glycated haemoglobin (HbA1a, HbA1b, and HbA1c). The level of HbA1c reflects ambient blood sugar concentrations during the life span of the patients red cells (half life about 68 weeks)that is, uncontrolled hyperglycaemia results in high HbA1c levels. Current Continue reading >>

A1c Test

A1c Test

Print Overview The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes. The A1C test goes by many other names, including glycated hemoglobin, glycosylated hemoglobin, hemoglobin A1C and HbA1c. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. Why it's done An international committee of experts from the American Diabetes Association, the European Association for the Study of Diabetes and the International Diabetes Federation, recommend that the A1C test be the primary test used to diagnose prediabetes, type 1 diabetes and type 2 diabetes. After a diabetes diagnosis, the A1C test is used to monitor your diabetes treatment plan. Since the A1C test measures your average blood sugar level for the past two to three months instead of your blood sugar level at a specific point in time, it is a better reflection of how well your diabetes treatment plan is working overall. Your doctor will likely use the A1C test when you're first diagnosed with diabetes. This also helps establish a baseline A1C level. The test may then need to be repeated while you're learning to control your blood sugar. Later, how often you need the A1C test depends on the type of diabetes you have, your treatment plan and how well you're managing your blood sugar. For example, the A1C test may be recommended: Once every year if you have prediabetes, which indicates a high risk of developing diabetes Twice a year if Continue reading >>

Low Hba1c Is As Bad Or Worse Than High Hba1c In Non-diabetics

Low Hba1c Is As Bad Or Worse Than High Hba1c In Non-diabetics

This study looked at roughly 14,000 NHANES III participants that were not diabetic. I think this is an important distinction because it looks at differences in normal range, "free", if you will, of what the frank hyperglycemia associated with metabolic dysfunction might do to mean and/or median values. Here is the hazard ratio plot: Adjusted hazard ratios for the association between HbA1c and all-cause mortality among participants without diabetes using a quadratic spline with knots at the 2.5, 10, 50, 90, and 97.5 percentiles. Adjusted for age, race-ethnicity, sex, lifestyle factors (education, income, current smoking, alcohol consumption, physical activity, body mass index, and aspirin use), cardiovascular factors (systolic blood pressure, antihypertensive medication use, total cholesterol, HDL cholesterol, log triglycerides, elevated C-reactive protein, and history of CVD), metabolic factors (prior diagnosis of thyroid disease, thyroid-stimulating hormone, estimated glomerular filtration rate, and albuminuria), red blood cell indices (hemoglobin, red blood cell distribution width, mean cell volume, and serum folate), iron storage indices (serum albumin, ferritin, and transferrin saturation), and liver function indices (hepatitis C seropositivity, AST, and ALT). Knots were placed at 4.3%, 4.7%, 5.3%, 5.9%, and 6.2%, representing HbA1c levels at the 2.5, 10, 50, 90, and 97.5 percentiles; shaded area represents 95% CI. To repeat from the caption -- HbA1c of 4.3% corresponds with the 2.5th percentile meaning only 2.5% of non-diabetics have levels this low (this percentage would be even lower for the entire population including diabetics). I would note that the 50th percentile (aka the median) is at 5.3%, but you go all the way up to the 90th percentile and reach a whoppi Continue reading >>

Is A Lower A1c Level Better Or Worse?

Is A Lower A1c Level Better Or Worse?

It seems logical that the lower our blood glucose levels are the better we will be. Most of us have always assumed that lower blood glucose levels would protect us better from the complications of diabetes. In fact, during the past two decades several studies showed a linear relationship between blood glucose, as measured by A1C levels, and worsened health. But now, several recent A1C studies have shown a J-shaped relationships, in which at the lower end some bad things happen, at the center things are better, and at the top end things are terrible. While linear relationships are the rule in observational studies, U-shaped and J-shaped curves aren’t uncommon, and some authors lump both of these shapes as U-shaped. All of the studies relating A1C levels and ill health — the earlier ones and the recent ones alike — are observational. They study correlations, which aren’t proof, because other confounding factors that the researchers didn’t take into account could have been the problem. 5.4-5.6 Seems Safest The first of these newer studies showing that a very low A1C level is unhealthier than a higher one came out in the February 2015 issue of Diabetes Care. This analysis of the German National Health Interview and Examination Survey 1998 that studied about 6,300 people for about 12 years indicated that people with an A1C level of 5.4 to 5.6 had the lowest risk of excess mortality. Because this result puzzled me so much, I asked Dr. Richard K. Bernstein for his reaction. “These A1c measurements were made years ago in Germany,” he replied, “before international agreement on how it would be measured. The modern elution method would likely give considerably different results. It is even possible that several different methods were being used at different sites Continue reading >>

Falsely Decreased Hba1c In A Type 2 Diabetic Patient Treated With Dapsone - Sciencedirect

Falsely Decreased Hba1c In A Type 2 Diabetic Patient Treated With Dapsone - Sciencedirect

Volume 111, Issue 2 , February 2012, Pages 109-112 Author links open overlay panel Ying-ChuenLaia Chou-ShiangWangb Yi-ChingWangb Yu-LingHsub Lee-MingChuangb Glycated hemoglobin A1c (HbA1c) is an important indicator of glycemic control. The current recommendation for glycemic control based on HbA1c values has been widely accepted. However, HbA1c values depend on the lifespan of erythrocytes and the assay methods used. Here, we report the case of a patient with type 2 diabetes with unusual falling of HbA1c due to interference from dapsone treatment for leukocytoclastic vasculitis. He was a 52-year-old man, who was diagnosed with type 2 diabetes mellitus 5 years previously and who had been treated in our hospital in the past 3 years. Glycemia was controlled by sulfonylurea and metformin. During the 3-years follow-up period, HbA1c dropped significantly during the addition of dapsone treatment, although plasma glucose levels remained stable. HbA1c levels were raised after discontinuation of dapsone. With rechallenge of dapsone usage, HbA1c decreased again. We conclude that dapsone may be the cause of artificially low HbA1c. Other measurements to monitor glycemic control should be considered when dapsone is used for the treatment of concurrent disorders, such as autoimmune disease and pneumocystis jiroveci pneumonia. Continue reading >>

Drugs Affecting Hba1c Levels Unnikrishnan R, Anjana Rm, Mohan V - Indian J Endocr Metab

Drugs Affecting Hba1c Levels Unnikrishnan R, Anjana Rm, Mohan V - Indian J Endocr Metab

Diabetes mellitus has assumed epidemic proportions worldwide, causing much morbidity and mortality on account of its various complications. The development of chronic vascular complications of diabetes such as retinopathy, nephropathy and cardiovascular disease is intimately linked to the level of glycemic control attained by the individual with diabetes. Therefore, it is essential to have an index of the long-term glycemic control in diabetes patients, which in turn can be used to guide therapy and predict the likelihood of complications. Glycated hemoglobin (HbA1c) was first described by Rahbar et al. in 1969. [1] Subsequent studies showed that the level of HbA1c correlated well with the glycemic control over a period of 2 to 3 months, leading to the gradual incorporation of the test into clinical practice in the 1980s. [2] With the publication of the Diabetes Control and Complications Trial [3] and the United Kingdom Prospective Diabetes Study, [4] both of which correlated the HbA1c levels to the development of diabetes complications, HbA1c estimation has become established as a cornerstone of diabetes management. Hemoglobin (Hb) is a tetramer formed of two alpha and two beta globin chains. On exposure to high levels of blood glucose, hemoglobin gets non-enzymatically glycated at different sites in the molecule. HbA1c is formed when glucose gets added on to the N-terminal valine residue of the beta chain of Hb. [5] The levels of HbA1c in the blood reflect the glucose levels to which the erythrocyte has been exposed during its lifespan (approximately 117 days in men and 106 days in women). Therefore, the HbA1c is an index of the level of glycemic control over the preceding 2 to 3 months. Of this period, the immediately preceding 30 days contribute 50% to HbA1c. [5] A Continue reading >>

Factors That Interfere With Hba1c Test Results

Factors That Interfere With Hba1c Test Results

Information for physicians and patients regarding HbS, HbC, HbE and HbD traits More about hemoglobin variants and HbA1c can also be found at the NIDDK web site: Sickle Cell Trait and Other Hemoglobinopathies and Diabetes: Important Information for Physicians For People of African, Mediterranean, or Southeast Asian Heritage: Important Information about Diabetes Blood Tests Factors that Interfere with HbA1c Measurement: Genetic variants (e.g. HbS trait, HbC trait), elevated fetal hemoglobin (HbF) and chemically modified derivatives of hemoglobin (e.g. carbamylated Hb in patients with renal failure) can affect the accuracy of HbA1c measurements. The effects vary depending on the specific Hb variant or derivative and the specific HbA1c method. Table 1 contains information for most of the commonly used current HbA1c methods for the four most common Hb variants, elevated HbF and carbamylated Hb. Interferences from less common Hb variants and derivatives are discussed in Bry, et al [1]. All entries in Table 1 are based on published information. In addition, if a product insert indicates clearly that there is inference from a particular factor, then the interference is entered as “yes” and the product insert is cited. When selecting an assay method, laboratories should take into consideration characteristics of the patient population served, (e.g. high prevalence of hemoglobinopathies or renal failure). Factors that affect interpretation of HbA1c Results: Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss, hemolytic anemia) will falsely lower HbA1c test results regardless of the assay method used [2]. HbA1c results from patients with HbSS, HbCC, and HbSC must be interpreted with caution given the patholog Continue reading >>

Test Id: Hba1c Hemoglobin A1c, Blood

Test Id: Hba1c Hemoglobin A1c, Blood

Evaluating the long-term control of blood glucose concentrations in diabetic patients Diagnosing diabetes Identifying patients at increased risk for diabetes (prediabetes) Diabetes mellitus is a chronic disorder associated with disturbances in carbohydrate, fat, and protein metabolism characterized by hyperglycemia. It is one of the most prevalent diseases, affecting approximately 24 million individuals in the United States. Long-term treatment of the disease emphasizes control of blood glucose levels to prevent the acute complications of ketosis and hyperglycemia. In addition, long-term complications such as retinopathy, neuropathy, nephropathy, and cardiovascular disease can be minimized if blood glucose levels are effectively controlled. Hemoglobin A1c (HbA1c) is a result of the nonenzymatic attachment of a hexose molecule to the N-terminal amino acid of the hemoglobin molecule. The attachment of the hexose molecule occurs continually over the entire life span of the erythrocyte and is dependent on blood glucose concentration and the duration of exposure of the erythrocyte to blood glucose. Therefore, the HbA1c level reflects the mean glucose concentration over the previous period (approximately 8-12 weeks, depending on the individual) and provides a much better indication of long-term glycemic control than blood and urinary glucose determinations. Diabetic patients with very high blood concentrations of glucose have from 2 to 3 times more HbA1c than normal individuals. Diagnosis of diabetes includes 1 of the following: -Fasting plasma glucose > or =126 mg/dL -Symptoms of hyperglycemia and random plasma glucose >or =200 mg/dL -Two-hour glucose > or =200 mg/dL during oral glucose tolerance test unless there is unequivocal hyperglycemia, confirmatory testing should be Continue reading >>

5 Ways To Lower Your A1c

5 Ways To Lower Your A1c

For some, home blood sugar testing can be an important and useful tool for managing your blood sugar on a day-to-day basis. Still, it only provides a snapshot of what’s happening in the moment, not long-term information, says Gregory Dodell, MD, assistant clinical professor of medicine, endocrinology, diabetes, and bone disease at Mount Sinai Health System in New York City. For this reason, your doctor may occasionally administer a blood test that measures your average blood sugar level over the past two to three months. Called the A1C test, or the hemoglobin A1C test, this provides a more accurate picture of how well your type 2 diabetes management plan is working. Taking the A1C Test If your diabetes is well controlled and your blood sugar levels have remained stable, the American Diabetes Association recommends that you have the A1C test two times each year. This simple blood draw can be done in your doctor's office. Some doctors can use a point-of-care A1C test, where a finger stick can be done in the office, with results available in about 10 minutes. The A1C test results provide insight into how your treatment plan is working, and how it might be modified to better control the condition. Your doctor may want to run the test as often as every three months if your A1C is not within your target range. What the A1C Results Mean The A1C test measures the glucose (blood sugar) in your blood by assessing the amount of what’s called glycated hemoglobin. “Hemoglobin is a protein within red blood cells. As glucose enters the bloodstream, it binds to hemoglobin, or glycates. The more glucose that enters the bloodstream, the higher the amount of glycated hemoglobin,” Dr. Dodell says. An A1C level below 5.7 percent is considered normal. An A1C between 5.7 and 6.4 perce Continue reading >>

An Elevated Risk State?

An Elevated Risk State?

Go to: Abstract To identify predictors of low hemoglobin A1c (HbA1c) (<5.0%) and to investigate the association of low HbA1c with cause-specific mortality and risk of liver disease hospitalization. RESEARCH DESIGN AND METHODS Prospective cohort study of 13,288 participants in the Atherosclerosis Risk in Communities Study. Logistic regression was used to identify cross-sectional correlates of low HbA1c, and Cox proportional hazards models were used to estimate the association of low HbA1c with cause-specific mortality. RESULTS Compared with participants with HbA1c in the normal range (5.0 to <5.7%), participants with low HbA1c were younger, less likely to smoke, had lower BMI, lower white cell count and fibrinogen levels, and lower prevalence of hypercholesterolemia and history of coronary heart disease. However, this group was more likely to have anemia and had a higher mean corpuscular volume. In adjusted Cox models with HbA1c of 5.0 to <5.7% as the reference group, HbA1c <5.0% was associated with a significantly increased risk of all-cause mortality (hazard ratio [HR]: 1.32, 95% CI: 1.13–1.55) and of cancer death (1.47, 95% CI: 1.16–1.84). We also noted nonsignificant trends toward increased risk of death from cardiovascular causes (1.27, 95% CI: 0.93–1.75) and respiratory causes (1.42, 95% CI: 0.78–2.56). There was a J-shaped association between HbA1c and risk of liver disease hospitalization. No single cause of death appeared to drive the association between low HbA1c and total mortality. These results add to evidence that low HbA1c values may be a generalized marker of mortality risk in the general population. Adjusted* associations of low HbA1c (<5.0% vs. 5.0 to <5.7%) among persons without diabetes (N = 9,254) Continue reading >>

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