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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Nonlinear relationship between HbA1c and coronary artery calcium score progression: a secondary analysis based on a

Jing Yu1, Bo Gao2,3

  • 1Department of Medical Imaging, Guizhou Medical University, Guiyang, 550004, Guizhou Province, China.

Diabetology & Metabolic Syndrome
|November 20, 2021
PubMed

Insights

Glycated hemoglobin (HbA1c) shows a nonlinear association with coronary artery calcium score progression. Levels below 5.8% are positively linked to increased coronary artery calcium scores, a key indicator of heart disease risk.

Area of Science:

  • Cardiology
  • Endocrinology
  • Preventive Medicine

Background:

  • Coronary artery calcium (CAC) score and glycated hemoglobin (HbA1c) are established risk factors for coronary heart disease (CHD).
  • The precise relationship between CAC score progression and HbA1c levels remains incompletely understood.
  • Understanding this association is crucial for refining cardiovascular risk stratification.

Purpose of the Study:

  • To investigate the association between HbA1c levels and the progression of CAC score.
  • To explore the nature of this relationship, specifically identifying any nonlinear patterns.
  • To provide insights into cardiovascular risk assessment in the South Korean population.

Main Methods:

  • Secondary analysis of a retrospective cohort study involving 8151 participants.
  • Data collected from health examinations conducted between March 1, 2003, and December 31, 2013.
  • Cox proportional-hazards regression models were employed to assess the relationship between HbA1c and CAC score progression, adjusting for multiple confounders.

Main Results:

  • A nonlinear relationship was identified between HbA1c and CAC score progression, with an inflection point at 5.8% HbA1c.
  • An effect size of 2.06 (95% CI: 1.85–2.29) was observed for CAC score progression with HbA1c levels below 5.8%.
  • An effect size of 1.04 (95% CI: 0.99–1.10) was noted for CAC score progression with HbA1c levels above 5.8%.

Conclusions:

  • The association between HbA1c and CAC score progression is nonlinear.
  • Elevated HbA1c levels, particularly below 5.8%, are significantly associated with accelerated CAC score progression.
  • These findings highlight the importance of monitoring HbA1c for predicting coronary heart disease risk.
Abstract

Keywords:
Coronary artery calcium scoreCoronary atherosclerotic heart diseaseGlycated hemoglobin

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