Association of fasting glucose and glycated hemoglobin with the long-term risk of incident metabolic syndrome: Korean Genome and Epidemiology Study (KoGES)
- 74 Downloads
Previous studies have proposed potential benefit of glycated hemoglobin (HbA1c) supplementary to fasting glucose in detecting metabolic syndrome (MetS). This study was to investigate an association of incident MetS with levels of HbA1c and fasting glucose.
In a cohort of Korean Genome and Epidemiology Study, 5515 non-diabetic adults were grouped by the levels of baseline fasting glucose and HbA1c, and followed-up for 10 years. Using multivariate Cox proportional hazards assumption, hazards ratios (HRs) and 95% confidence interval (CI) for incident MetS (adjusted HRs [95% CI]) were calculated according to baseline fasting glucose and HbA1c. In individuals with normal fasting glucose, subgroup analysis was conducted to evaluate an association of HbA1c levels with MetS.
The risk for MetS significantly increased proportionally to fasting glucose ≥ 80 mg/dL and HbA1c ≥ 5.5%, compared with fating glucose < 80 mg/dL and HbA1c < 5.3%, respectively. In subgroups of normal fasting glucose, HbA1c ≥ 5.7% had the increased risk of MetS in fasting glucose < 80 mg/dL (5.7–5.9%: 1.41 [1.07–1.86] and 6.0–6.4%: 2.20 [1.40–2.92]), and HbA1c ≥ 5.5% had the increased risk of MetS in fasting glucose of 80–99 mg/dL (5.5–5.6%: 1.33 [1.08–1.64], 5.7–5.9%: 1.57 (1.27–1.93), and 6.0–6.4%: 2.37 [1.87–3.00]).
Both elevated fasting glucose and HbA1c were significantly associated with the increased risk of MetS even within normal range. HbA1c is effective in identifying high-risk group for MetS in individuals with normal fasting glucose.
KeywordsFasting glucose Glycated hemoglobin Metabolic syndrome
Data in this study were from the Korean Genome and Epidemiology Study (KoGES; 4851-302), National Research Institute of Health, Centers for Disease Control and Prevention, Ministry for Health and Welfare, Republic of Korea.
Ju Young Jung coordinated the study, analyzed the data, and wrote the manuscript as a first author. Jae-Hong Ryoo and Pil-Wook Chung participated in conducting study and writing manuscript. Chang-Mo Oh played role in analyzing data and verifying the results. Joong-Myung Choi participated in English editing and reviewing manuscript. Sung Keun Park is the guarantor of this work and, as such, had full access to all the data in the study, and takes responsibility for the integrity of the data and the accuracy of the data analysis.
The authors have nothing to disclose. This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics approvals for the study protocol and analysis of the data were obtained from the institutional review board of Kangbuk Samsung Hospital.
Informed consent was obtained from all individual participants included in the study.
- 1.Alberti KG, Eckel RH, Grundy SM et al., Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009; 120:1640–1645CrossRefGoogle Scholar
- 3.Roberts CK, Hevener AL, Barnard RJ (2013) Metabolic syndrome and insulin resistance: underlying causes and modification by exercise training. Compr Physiol 3:1–58Google Scholar
- 14.American Diabetes Association (2016) Standards of Medical Care in Diabete 2016. Diabetes Care 39(Suppl. 1):S13–S22Google Scholar
- 28.Haffner S (2001) The importance of postprandial hyperglycaemia in development of cardiovascular disease in people with diabetes. Int J Clin Pract 123:24–26Google Scholar