RESULTS Incidence of diabetes during the follow-up was 17.1%. Two of three of the cases of newly diagnosed diabetes were predicted by a raise in ≥1 of the markers. Elevated A1C, IGT, or IFG preceded diabetes in 32.8, 40.6, and 21.9%, respectively. CVD was predicted by an intermediate and diabetic range of 2-h glucose but only by diabetic A1C levels in women.
CONCLUSIONS A1C predicted 10-year risk of type 2 diabetes at a range of A1C 5.7–6.4% but CVD only in women at A1C ≥6.5%.
I stumbled across this article while evaluating a persistent CPK elevation in an applicant with HLD and other CHD risk factors.
I think I’m in trouble.
If the guidelines are adopted in the fall, as expected, some experts predict a two- to threefold increase in the number of people with Alzheimer’s disease. Many more people would be told they probably are on their way to getting it.
Remember, we do not use race in our underwriting.
Conclusions: The investigators concluded that these findings do not support the use of NT-proBNP as a cardiovascular biomarker in healthy normal subjects, and have important implications for NT-proBNP–based strategies for early detection and primary prevention of cardiovascular disease.
High levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) were an independent risk factor for non-vascular mortality as well as for cardiovascular death, stroke, and coronary heart disease in a large meta-analysis.
For each standard deviation above the mean for Lp-PLA2 among nearly 80,000 participants in 32 prospective studies, the risk of non-vascular death increased by 10% after adjusting for conventional risk factors, reported Alexander Thompson, of the University of Cambridge in England, and 14 other members of the Lp-PLA2 Studies Collaboration in the May 1 Lancet.
For the current study, Selvin and her colleagues measured A1C from more than 11,000 stored blood samples from the Atherosclerosis Risk in Communities Study, which began in 1990. None of the study volunteers had diabetes or cardiovascular disease at the time the blood samples were taken.
The researchers then compared the A1C levels to fasting blood sugar levels and to the 15 years of overall health follow-up information gathered for the previous study.
During that time, 2,251 people were diagnosed with diabetes, nearly 1,200 were diagnosed with heart disease and 358 people had an ischemic (non-bleeding) stroke, according to the study.
As expected, the researchers found that elevated A1C levels were associated with an increased risk of being diagnosed with diabetes. Those with an A1C of less than 5 percent had a 48 percent reduced risk of diabetes, while people whose A1Cs were between 5 and 5.5 percent had a normal risk of diabetes. From there, however, the risk quickly went up. Those with an A1C of 5.5 to 6 percent had an 86 percent increased risk of diabetes. For those between 6 and 6.5 percent, the risk more than quadrupled. For people with levels above 6.5 percent, the odds of being diagnosed were more than 16 times higher than for someone with levels under 5.5 percent. These results were similar to those for fasting glucose levels, the study authors noted.
Where fasting glucose and A1C differed greatly, however, was in the prediction of future heart disease and stroke risk. While fasting glucose failed to predict future risk, the study found that A1C levels accurately did so.
People with A1Cs under 5.5 percent had an average risk of heart disease and stroke, but for people with an A1C between 5.5 and 6 percent, the risk went up 23 percent. For those with an A1C between 6 and 6.5 percent, the risk of cardiovascular disease jumped to 78 percent. When A1C went over 6.5 percent, the risk of cardiovascular disease went up nearly twofold.
Results of the study are published in the March 4 issue of the New England Journal of Medicine.