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Inconvenient relationship of haemoglobin A1c level with endothelial function in type 2 diabetes in a cross-sectional study.
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- Author(s): Yamaji T;Yamaji T; Harada T; Harada T; Hashimoto Y; Hashimoto Y; Takaeko Y; Takaeko Y; Kajikawa M; Kajikawa M; Han Y; Han Y; Maruhashi T; Maruhashi T; Kishimoto S; Kishimoto S; Hashimoto H; Hashimoto H; Kihara Y; Kihara Y; Hida E; Hida E; Chayama K; Chayama K; Goto C; Goto C; Yusoff FM; Yusoff FM; Nakashima A; Nakashima A; Higashi Y; Higashi Y; Higashi Y
- Source:
BMJ open [BMJ Open] 2021 Jun 09; Vol. 11 (6), pp. e045415. Date of Electronic Publication: 2021 Jun 09.- Publication Type:
Journal Article; Research Support, Non-U.S. Gov't- Language:
English - Source:
- Additional Information
- Source: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
- Publication Information: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
- Subject Terms:
- Abstract: Objective: 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.
Design: Cross-sectional study.
Setting: 22 university hospitals and affiliated clinics in Japan.
Participants: 1215 patients with type 2 diabetes including 349 patients not taking antidiabetic drugs.
Measures: 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%.
Results: 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.
Conclusions: 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.
Trial Registration Number: UMIN000012950, UMIN000012951, UMIN000012952 and UMIN000003409.
Competing Interests: Competing interests: None declared.
(© 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.) - References: N Engl J Med. 2010 Oct 7;363(15):1410-8. (PMID: 20925543)
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- Molecular Sequence: UMIN-CTR UMIN000012950; UMIN000012951; UMIN000012952; UMIN000003409
- Accession Number: 0 (Glycated Hemoglobin A)
- Publication Date: Date Created: 20210610 Date Completed: 20210618 Latest Revision: 20221207
- Publication Date: 20231215
- Accession Number: PMC8191618
- Accession Number: 10.1136/bmjopen-2020-045415
- Accession Number: 34108164
- Source:
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