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HbA1c and the risks for all-cause and cardiovascular mortality in the general Japanese population: NIPPON DATA90

Masaru Sakurai1, Shigeyuki Saitoh, Katsuyuki Miura

  • 1Corresponding author: Masaru Sakurai, m-sakura@kanazawa-med.ac.jp.

Diabetes Care
|July 24, 2013
PubMed

Insights

High hemoglobin A1c (HbA1c) levels are linked to increased cardiovascular disease (CVD) mortality risk in East Asian populations. This finding supports using HbA1c for CVD risk assessment in this demographic.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Glycemic control, measured by hemoglobin A1c (HbA1c), is crucial for managing diabetes.
  • Previous studies primarily from Western countries suggest a link between HbA1c levels and cardiovascular disease (CVD) risk.
  • The utility of HbA1c for predicting CVD mortality in East Asian populations remains less clear.

Purpose of the Study:

  • To investigate the association between HbA1c levels and the risk of cardiovascular death in a large Japanese cohort.
  • To determine if HbA1c is a useful biomarker for assessing CVD mortality risk in East Asian populations.

Main Methods:

  • A prospective cohort study involving 7,120 Japanese adults without prior CVD.
  • Participants were categorized by HbA1c levels (<5.0%, 5.0-5.4%, 5.5-5.9%, 6.0-6.4%, and ≥6.5%).
  • Cox proportional hazards models were used to calculate adjusted hazard ratios for cardiovascular death over a 15-year follow-up period.

Main Results:

  • A graded and continuous relationship was observed between HbA1c levels and both all-cause and CVD mortality.
  • Participants with HbA1c levels of 6.0-6.4% and ≥6.5% had significantly increased adjusted hazard ratios for CVD death (2.18 and 2.75, respectively) compared to those with HbA1c <5.0%.
  • Similar associations were found for deaths from coronary heart disease and cerebral infarction.

Conclusions:

  • Elevated HbA1c levels are associated with a higher risk of all-cause mortality and death from CVD, coronary heart disease, and cerebral infarction in the general East Asian population.
  • These findings are consistent with those observed in Western populations, suggesting HbA1c is a valuable predictor of CVD mortality across diverse ethnic groups.
  • HbA1c measurements can be effectively utilized for assessing cardiovascular mortality risk in East Asian individuals.
Abstract

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