Inconvenient relationship of haemoglobin A1c level with endothelial function in type 2 diabetes in a cross-sectional study.
cardiology
diabetes & endocrinology
general diabetes
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
09 06 2021
09 06 2021
Historique:
entrez:
10
6
2021
pubmed:
11
6
2021
medline:
22
6
2021
Statut:
epublish
Résumé
The aim of this study was to determine the relationship of haemoglobin A1c (HbA1c) level with flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) in patients with type 2 diabetes. Cross-sectional study. 22 university hospitals and affiliated clinics in Japan. 1215 patients with type 2 diabetes including 349 patients not taking antidiabetic drugs. We evaluated FMD and HbA1c level. All patients were divided into four groups based on HbA1c level: <6.5%, 6.5%-6.9%, 7.0%-7.9% and ≥8.0%. An inverted U-shaped pattern of association between HbA1c level and FMD was observed at the peak of HbA1c of about 7%. FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%-6.9% group and HbA1c 7.0%-7.9% group (p<0.001 and p<0.001), and FMD values were similar in the HbA1c <6.5% group and HbA1c ≥8.0% group. There were no significant differences in NID values among the four groups. After adjustments for confounding factors, FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%-6.9% and HbA1c 7.0%-7.9% group (p=0.002 and p=0.04). In patients not taking antidiabetic drugs, FMD was also significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%-6.9% group and HbA1c 7.0%-7.9% group (p<0.001 and p=0.02), and there were no significant differences in NID values among the four groups. These findings suggest that there is an inverted U-shaped pattern of association between FMD and HbA1c and that a low HbA1c level of <6.5% is associated with endothelial dysfunction. UMIN000012950, UMIN000012951, UMIN000012952 and UMIN000003409.
Identifiants
pubmed: 34108164
pii: bmjopen-2020-045415
doi: 10.1136/bmjopen-2020-045415
pmc: PMC8191618
doi:
Substances chimiques
Glycated Hemoglobin A
0
Banques de données
UMIN-CTR
['UMIN000012950', 'UMIN000012951', 'UMIN000012952', 'UMIN000003409']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e045415Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
N Engl J Med. 2010 Oct 7;363(15):1410-8
pubmed: 20925543
Pharmacol Ther. 2004 Apr;102(1):87-96
pubmed: 15056500
Diabetes Care. 1993 Feb;16(2):434-44
pubmed: 8432214
Cardiovasc Diabetol. 2014 Jul 30;13:110
pubmed: 25074318
Eur Heart J. 2006 Jul;27(13):1605-9
pubmed: 16762982
Int J Cardiol. 2018 Mar 1;254:284-290
pubmed: 29407110
Int J Cardiol. 2017 Aug 15;241:30-34
pubmed: 28341376
Heart. 2013 Dec;99(24):1837-42
pubmed: 24153417
Diabetes Care. 2018 Jan;41(Suppl 1):S13-S27
pubmed: 29222373
Diabetes Res Clin Pract. 1995 May;28(2):103-17
pubmed: 7587918
BMJ. 2000 Aug 12;321(7258):405-12
pubmed: 10938048
N Engl J Med. 2018 Aug 16;379(7):633-644
pubmed: 30110583
Diabetes Metab Res Rev. 2008 Jul-Aug;24(5):353-63
pubmed: 18461635
J Clin Hypertens (Greenwich). 2018 May;20(5):910-917
pubmed: 29729072
Am J Physiol. 1990 Jun;258(6 Pt 2):H1775-9
pubmed: 1972868
Circ J. 2009 Mar;73(3):411-8
pubmed: 19194043
Atherosclerosis. 2004 May;174(1):49-56
pubmed: 15135250
J Diabetes Complications. 2006 Nov-Dec;20(6):395-401
pubmed: 17070446
Am J Hypertens. 2002 Apr;15(4 Pt 1):302-9
pubmed: 11991214
Arterioscler Thromb Vasc Biol. 2011 Oct;31(10):2353-9
pubmed: 21737782
Chest. 2004 Mar;125(3):823-30
pubmed: 15006938
N Engl J Med. 2010 Jul 15;363(3):233-44
pubmed: 20587587
Hypertension. 1999 Jan;33(1 Pt 2):591-7
pubmed: 9931171
Diabetologia. 1996 Dec;39(12):1540-5
pubmed: 8960840
PLoS One. 2012;7(6):e38877
pubmed: 22719972
Int Heart J. 2012;53(3):170-5
pubmed: 22790685
Ann Intern Med. 2004 Sep 21;141(6):413-20
pubmed: 15381514
J Korean Med Sci. 2012 Nov;27(11):1364-70
pubmed: 23166419
N Engl J Med. 2008 Jun 12;358(24):2545-59
pubmed: 18539917
Nature. 2001 Dec 13;414(6865):813-20
pubmed: 11742414
Arch Endocrinol Metab. 2017 Dec;61(6):542-549
pubmed: 28724057
Arterioscler Thromb Vasc Biol. 2013 Jun;33(6):1401-8
pubmed: 23520168
Rev Diabet Stud. 2014 Summer;11(2):138-52
pubmed: 25396402
Circulation. 2003 Aug 5;108(5):530-5
pubmed: 12874192
Diabetes Care. 2017 Apr;40(4):453-460
pubmed: 28223299
Circulation. 2009 Aug 11;120(6):502-9
pubmed: 19635967
JAMA. 2001 May 16;285(19):2486-97
pubmed: 11368702
J Am Coll Cardiol. 1996 Mar 1;27(3):567-74
pubmed: 8606266
N Engl J Med. 2009 Jan 8;360(2):129-39
pubmed: 19092145
N Engl J Med. 2008 Jun 12;358(24):2560-72
pubmed: 18539916
J Am Coll Cardiol. 2016 Feb 2;67(4):456-458
pubmed: 26821636
Eur Heart J. 2013 Oct;34(40):3137-44
pubmed: 23999452