Hemoglobin A1c and abdominal obesity as predictors of diabetes and atherosclerotic cardiovascular disease (ASCVD) in individuals with prediabetes in UK Biobank: a prospective observational study
Authors' conclusion
The risks of progression to both new onset DM and ASCVD are significantly greater in the prediabetic population. This underscores the importance of preventing the development of DM and efforts to reduce cardiometabolic risk through optimizing multiple risk factors in both categories of prediabetes. Risk modification by waist circumference suggests weight and glucose lowering therapies should be targeted at those with highest risks.
Study context
- Population
- Women and men aged 40–73, UK Biobank, free of ASCVD and diabetes mellitus (DM) at baseline
- Participants
- 296,470 women
- Exposure
- Low and high prediabetes vs normal HbA1c
- Outcome
- ASCVD and new onset DM risk
- Follow-up
- 10 years
Methodological detailspopulation-based (UK Biobank), multivariate-adjusted Cox regression, stratified by sex
- Population-based (UK Biobank)
- Multivariate-adjusted Cox regression
- Stratified by sex
Main finding
As reported in the abstract
ASCVD
Each group vs normal HbA1cHazard ratio (95% CI)
Low prediabeteswomen
1.08(1.01,1.15)
High prediabeteswomen
1.25(1.14,1.38)
Low prediabetesmen
1.18(1.11,1.24)
High prediabetesmen
1.27(1.17,1.38)
Observational data: associations, not effects.
Further findings
New onset DM · 10 years
| HR (95% CI) | ||
|---|---|---|
| Low prediabetic womenMultivariate-adjusted | 4.05 (3.73,4.40) | |
| High pre-diabetic womenMultivariate-adjusted | 14.22 (13.06,15.49) | |
| Low prediabetic menMultivariate-adjusted | 4.45 (4.12,4.80) | |
| High pre-diabetic menMultivariate-adjusted | 15.59 (14.43,16.85) | |
| 0.050.21520Hazard ratio (log scale) |
- Associations with new onset DM substantially more potent than with ASCVD
DM risk by waist circumference
- Increasing waist circumference in low prediabetic men and all prediabetic women associated with meaningful increase in DM risk
Original publication
Hemoglobin A1c and abdominal obesity as predictors of diabetes and ASCVD in individuals with prediabetes in UK Biobank: a prospective observational study. Cardiovasc Diabetol. Published 19 December 2024. doi:10.
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