Association between hemoglobin A_1c, carotid atherosclerosis, arterial stiffness, and peripheral arterial disease in Korean type 2 diabetic patients

Abstract 

Aims

To evaluate the association between hemoglobin A_1c (HbA_1c), carotid atherosclerosis, arterial stiffness, and peripheral arterial disease (PAD) in Korean type 2 diabetic patients.

Methods

A total of 370 type 2 diabetic patients registered with the public health center in Gokseng-gun, Korea, participated in this study. Following an overnight fast, venous blood was collected and analyzed by high-performance liquid chromatography. The carotid intima-media thickness (IMT), amount of carotid plaque, brachial ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) of each patient were also assessed.

Results

For categorical variables, we performed logistic regression after adjustment for other CVD risk factors. There was a significant association between HbA_1c and carotid plaque [OR 2.66, 95% confidence interval (CI) 1.01 to 5.67 for the highest vs. the lowest tertile of HbA_1c], and PAD (OR 3.75, 95% CI 1.30 to 10.81). For continuous variables, we performed analysis of covariance (ANCOVA) after adjustment for other covariates. The mean values of common carotid artery intima-media thickness (CCA-IMT) and baPWV were not significantly different according to the HbA_1c tertiles.

Conclusion

HbA_1c was significantly associated with carotid plaque and PAD, but not CCA-IMT and baPWV in Korean type 2 diabetic patients.

Keywords: Diabetes mellitus, Type 2, Hemoglobin A, Glycosylated, Carotid atherosclerosis, Arterial stiffness, Peripheral vascular disease