Glycated hemoglobin levels are mostly dependent on nonglycemic parameters in 9398 Finnish men without diabetes
Maria Fizelova1, Alena Stančáková, Carlos Lorenzo
1Institute of Clinical Medicine (M.F., A.S., H.C., J.K., M.L.), Department of Internal Medicine, University of Eastern Finland, and Institute of Clinical Medicine (H.C., J.K., M.L.), Department of Internal Medicine, University of Eastern Finland, Kuopio, and Kuopio University Hospital, 70210 Kuopio, Finland; Department of Medicine (C.L., S.M.H.), University of Texas Health Science Center, San Antonio, Texas 78229.
Context:
Determinants of the variance in glycated hemoglobin (HbA1c) among individuals without type 2 diabetes remain largely unknown.
Objective:
We investigated the determinants of HbA1c, fasting plasma glucose, and 2-hour glucose in an oral glucose tolerance test and the associations of these glycemic markers with insulin sensitivity and insulin secretion in Finnish men without type 2 diabetes.
Design And Setting:
The design and setting were the cross-sectional population-based Metabolic Syndrome in Men study including 10 197 Finnish men, aged 45-70 years, and randomly selected from the population register of Kuopio, Eastern Finland.
Participants:
Participants were a total of 9398 men without type 2 diabetes or with newly diagnosed type 2 diabetes at baseline (mean age 57 ± 7 y; body mass index 27.0 ± 4.0 kg/m(2), mean ± SD) in the Metabolic Syndrome in Men study cohort.
Interventions:
The intervention included an oral glucose tolerance test.
Main Outcome Measures:
Glycemic and nonglycemic determinants of the variance in HbA1c among participants without type 2 diabetes and the association of HbA1c with insulin secretion and insulin sensitivity were measured.
Results:
Age, fasting plasma glucose, and high-sensitivity C-reactive protein were the strongest determinants of HbA1c, explaining 12% of the variance in HbA1c levels in participants without type 2 diabetes. Disposition index (insulin secretion) and the Matsuda insulin sensitivity index (insulin sensitivity) explained only less than 2% of the variance in HbA1c in the participants without type 2 diabetes.
Conclusions:
The variance in HbA1c among men without type 2 diabetes was largely determined by nonglycemic factors and only weakly by impaired insulin sensitivity and insulin secretion.
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