Hemoglobin A1c and Arterial and Ventricular Stiffness in Older Adults

Susan J. Zieman, Aruna Kamineni, Joachim H. Ix, Joshua Barzilay, Luc Djoussé, Jorge R. Kizer, Mary L. Biggs, Ian H. de Boer, Michel Chonchol, John S. Gottdiener, Elizabeth Selvin, Anne B. Newman, Lewis H. Kuller, David S. Siscovick, Kenneth J. Mukamal

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Abstract

Objective: Arterial and ventricular stiffening are characteristics of diabetes and aging which confer significant morbidity and mortality; advanced glycation endproducts (AGE) are implicated in this stiffening pathophysiology. We examined the association between HbA1c, an AGE, with arterial and ventricular stiffness measures in older individuals without diabetes. Research Design & Methods: Baseline HbA1c was measured in 830 participants free of diabetes defined by fasting glucose or medication use in the Cardiovascular Health Study, a population-based cohort study of adults aged ≥65 years. We performed cross-sectional analyses using baseline exam data including echocardiography, ankle and brachial blood pressure measurement, and carotid ultrasonography. We examined the adjusted associations between HbA1c and multiple arterial and ventricular stiffness measures by linear regression models and compared these results to the association of fasting glucose (FG) with like measures. Results: HbA1c was correlated with fasting and 2-hour postload glucose levels (r = 0.21; p<0.001 for both) and positively associated with greater body-mass index and black race. In adjusted models, HbA1c was not associated with any measure of arterial or ventricular stiffness, including pulse pressure (PP), carotid intima-media thickness, ankle-brachial index, end-arterial elastance, or left ventricular mass (LVM). FG levels were positively associated with systolic, diastolic and PP and LVM. Conclusions: In this sample of older adults without diabetes, HbA1c was not associated with arterial or ventricular stiffness measures, whereas FG levels were. The role of AGE in arterial and ventricular stiffness in older adults may be better assessed using alternate AGE markers.

Original languageEnglish (US)
Article numbere47941
JournalPloS one
Volume7
Issue number10
DOIs
StatePublished - Oct 30 2012

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ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Zieman, S. J., Kamineni, A., Ix, J. H., Barzilay, J., Djoussé, L., Kizer, J. R., Biggs, M. L., de Boer, I. H., Chonchol, M., Gottdiener, J. S., Selvin, E., Newman, A. B., Kuller, L. H., Siscovick, D. S., & Mukamal, K. J. (2012). Hemoglobin A1c and Arterial and Ventricular Stiffness in Older Adults. PloS one, 7(10), [e47941]. https://doi.org/10.1371/journal.pone.0047941