Wednesday, March 26, 2014

Glycated Hemoglobin Test Don't Help In Cardiovascular Risk Predictions

Although measuring levels of blood glucose and glycated hemoglobin (HbA1c) are crucial for diabetes, association of these values with cardiovascular risk assessment is vague. Paper from the Emerging Risk Factors Collaboration, published in JAMA journal, showed results on analysis of almost 300,000 people without known diabetes and CVD history, who had individually gone through seventy-three prospective studies. The results stated that HbA1c isn't associated with clinically relevant improvement in CVD risk assessment. It was determined that adding information on HbA1c values to conventional cardiovascular risk factors provided little benefit for the assessment. Further, blood glucose information also did not significantly help in the identify people who need preventive treatment. Comparing measures of glycemia with cardiovascular risks at 4 different levels resulted in a surprising J-shaped curve. While lower levels of glycemia are generally associated with lower levels of risk, yet at the extreme lowest level there was a bounce back in the risk. Authors say this finding should be an impetus to test whether too low glycemia levels mark illness. It was also found that fasting, random, and postload glucose levels were of not much use in the assessment of CDV risk, just like the HbA1c. The study challenged the conventional phenomena that postload glucose levels prove better than other glycemia measures in predicting CVD incidence.

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