TY  - BOOK
AU  - Calhoun, Darren
AU  - Howard, Barbara V
AU  - Shara, Nawar M
AU  - Umans, Jason G
AU  - Wang, Hong
TI  - Hemoglobin A1c, fasting glucose, and cardiovascular risk in a population with high prevalence of diabetes: the strong heart study
SN  - 0149-5992
PY  - 2011///
KW  - *Blood Glucose/me [Metabolism]
KW  - *Cardiovascular Diseases/bl [Blood]
KW  - *Cardiovascular Diseases/me [Metabolism]
KW  - *Diabetes Mellitus/bl [Blood]
KW  - *Diabetes Mellitus/me [Metabolism]
KW  - *Hemoglobin A, Glycosylated/me [Metabolism]
KW  - Aged
KW  - Cardiovascular Diseases/ep [Epidemiology]
KW  - Diabetes Mellitus/ep [Epidemiology]
KW  - Fasting/bl [Blood]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Risk Factors
KW  - MedStar Health Research Institute
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSIONS: Individuals with known or newly diagnosed diabetes had increased risk for CVD. Although A1C is more convenient than FPG in diagnosing diabetes, neither test adds to conventional CVD risk factors in predicting CHD or total CVD; OBJECTIVE: We compared A1C and fasting plasma glucose (FPG) in predicting cardiovascular disease (CVD) in a population with widespread obesity and diabetes; RESEARCH DESIGN AND METHODS: A total of 4,549 American Indian adults underwent the Strong Heart Study (SHS) baseline examination (1989-1991). Data from 3,850 individuals (60% women) with baseline measurements of FPG and A1C and no prevalent CVD were analyzed; 1,386 had known diabetes. CVD events were ascertained over a median of 15 years; RESULTS: A1C >=6.5% had a 44.3% sensitivity and 98.9% specificity to identify participants with FPG >=126 mg/dL. Increases in A1C were associated with adverse CVD risk factor profiles; individuals with known diabetes had worse profiles. For A1C <5, 5 to <5.5, 5.5 to <6, 6-6.5, or >=6.5% or known diabetes, the multivariate-adjusted hazard ratio (HR) [95% CI] for coronary heart disease (CHD) was significant only for individuals with known diabetes (2.76 [2.17-3.51]). Similarly, the adjusted HRs for total CVD were significant only for individuals with A1C >=6.5% or known diabetes (1.50 [1.10-2.04] and 2.52 [2.06-3.08], respectively). Similar results were observed for FPG
UR  - http://dx.doi.org/10.2337/dc11-0329
ER  -