Abstract
The aim of this study is to assess the associations between glycosylated hemoglobin in the prediabetes range and cardiovascular risk markers in a rural South Indian population. Local Ethics Committee approval and informed consent was obtained from all participants. Inclusion criteria were participants, aged ≥20 and ≤85 years, from Nallampatti, a classical farming village from Tamil Nadu State, India. Those with known history of diabetes were excluded from this analysis. All participants were administered a detailed questionnaire, had anthropometric measurements including height, weight, and waist circumference. Bloods were drawn for random blood glucose, glycosylated hemoglobin, nonfasting lipid profile, cystatin C, uric acid, and hemoglobin. All participants had carotid intima thickness done by high-resolution B-mode carotid ultrasound. Progressive hyperglycemia across the glucose tolerance continuum based on glycosylated hemoglobin levels in a rural South Indian population seems to be associated with worsening cardiovascular risk markers. A cut-off value of ≥6% (42 mmol/mol) seems to herald a much more significant increase in such markers. Long-term follow-up of this cohort for incident cardiovascular disease will help to substantiate the associations between glycosylated hemoglobin levels within the prediabetes range and cardiovascular disease in an Indian population. Evidence-based race-specific criteria for diagnosis of prediabetes and diabetes are the need of the hour for risk stratification and appropriate management.
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Acknowledgments
We wish to acknowledge our KMCH Nursing Team, staff from Microbiological Laboratory, Coimbatore, and the village heads of Nallampatti, Mr. Velmurugan from IIT Madras, for their help with this study.
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K.S. wrote the first draft of the manuscript and researched the data. G.V. and S.K. performed statistical analyses and contributed the discussion. M.S. reviewed the data and edited the manuscript. N.G.P. is the guarantor of this study and reviewed the manuscript. All authors contributed to the data collection, study design, and data interpretation of this manuscript.
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Institutional Ethics Committee approval was obtained and all procedures performed in studies involving human participants were in accordance with the ethical standards of the institution.
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Both informed and written consent were obtained from all individual participants included in the study.
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Swaminathan, K., Veerasekar, G., Kuppusamy, S. et al. Glycosylated hemoglobin-defined prediabetes and cardiovascular risk markers in rural India: the Nallampatti noncommunicable disease study. Int J Diabetes Dev Ctries 38, 456–460 (2018). https://doi.org/10.1007/s13410-016-0532-3
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DOI: https://doi.org/10.1007/s13410-016-0532-3