Association and pathways of baseline and longitudinal hemoglobin A1c with the risk of incident stroke: A nationwide prospective cohort study
Authors' conclusion
Elevated levels of both baseline and long-term HbA1c were associated with increased risk of stroke, and hypertension and obesity played an important role in the pathway.
Study context
- Population
- Adults aged over 45 years without stroke at baseline, China Health and Retirement Longitudinal Study626 stroke cases
- Participants
- 11,220 adults
- Exposure
- Quintiles of baseline and mean hemoglobin A1c (HbA1c)
- Outcome
- Incident stroke
- Follow-up
- Median 7.50 years
Methodological detailsnationwide, multivariable-adjusted Cox regression, Bayesian network analysis
- Nationwide
- Multivariable-adjusted Cox regression
- Bayesian network analysis
Main finding
As reported in the abstract
Stroke risk by HbA1c quintile
Each group vs Q1Estimate (95 % CI)
Q5
HR (baseline HbA1c) 1.30(1.03–1.64)
Q5
HR (mean HbA1c) 1.79(1.38–2.34)
Observational data: associations, not effects.
Further findings
Stroke risk per 1 unit increase in HbA1c
- HR per 1 unit increase in baseline HbA1c
- 1.10 (95% CI 1.02-1.18)
- HR per 1 unit increase in mean HbA1c
- 1.12 (95% CI 1.05-1.19)
Pathways from HbA1c to stroke
- Pathway from HbA1c to stroke through hypertension, dyslipidemia, obesity and inflammation (Bayesian network)
Original publication
Association and pathways of baseline and longitudinal hemoglobin A1c with the risk of incident stroke: A nationwide prospective cohort study. Diabetes Res Clin Pract. Published 1 February 2024. doi:10.
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