Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk)
BMJPublished 6 January 2001Open access
K.‐T. Khaw
Citations1,019
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TL;DR
Glycated haemoglobin concentration seems to explain most of the excess mortality risk of diabetes in men and to be a continuous risk factor through the whole population distribution.
Abstract
Glycated haemoglobin concentration seems to explain most of the excess mortality risk of diabetes in men and to be a continuous risk factor through the whole population distribution. Preventive efforts need to consider not just those with established diabetes but whether it is possible to reduce the population distribution of HbA(1c) through behavioural means.
Keywords
MedicineBiochemistry, Genetics and Molecular Biology
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20,069 Citations1998
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Diabetic MedicineDefinition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation
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A WHO Consultation has taken place in parallel with a report by an American Diabetes Association Expert Committee to re‐examine diagnostic criteria and classification of diabetes mellitus and is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.
JNCI Journal of the National Cancer InstituteStatistical Aspects of the Analysis of Data From Retrospective Studies of Disease
14,860 Citations1959Nathan Mantel, William Haenszel
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7,008 Citations1998Steven M. Haffner, Seppo Lehto +3 more
It is suggested that diabetic patients without previous myocardial infarction have as high a risk of myocardia infarctions as nondiabetic patients with previous my Cardiac Arrest.
BMJTight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38
6,722 Citations1998UK Prospective Diabetes Study Group,
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Diabetes CareGlobal Burden of Diabetes, 1995–2025: Prevalence, numerical estimates, and projections
6,342 Citations1998Hilary King, Ronald E. Aubert +1 more
This report supports earlier predictions of the epidemic nature of diabetes in the world during the first quarter of the 21st century and provides a provisional picture of the characteristics of the diabetes epidemic.
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DiabetesClassification and Diagnosis of Diabetes Mellitus and Other Categories of Glucose Intolerance
4,942 Citations1979National Diabetes Data Group
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4,820 Citations1998M R Stearne, S L Palmer +261 more
Three computational fluid methodologies are employed, of varying levels of complexity with coupled 0D boundary conditions, to simulate the haemodynamics within a patient-specific aorta, demonstrating that, in the context of certain clinical questions, the simpler analysis methods may capture the important characteristics of the flow field.
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Diabetes CareDiabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial
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Available evidence suggests an involvement of AGEs in the pathogenesis of adiposity and β-cell failure in children, and potential areas for further research to investigate underlying mechanisms are proposed.
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AtherosclerosisPrevention of coronary heart disease in clinical practice: Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention1European Society of Cardiology, European Atherosclerosis Society, European Society of Hypertension, International Society of Behavioural Medicine, European Society of General Practice/Family Medicine, European Heart Network.1,2Published simultaneously in the European Heart Journal 1998;19:1434–1503 and the Journal of Hypertension (Summary only) 1998;16(10).2
1,264 Citations1998David Wood, Guy De Backer +4 more
The Task Force has summarized the most important clinical issues on coronary heart disease prevention on which there is good agreement in order to give cardiologists and physicians, and other health care professionals, the best possible advice to facilitate their work on coronaryHeart disease prevention.
Diabetes CareDiabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study
1,206 Citations1979W B Kannel, Dan McGee
Present evidence suggests that alleviation of associated cardiovascular risk factors is the most promising course in reducing cardiovascular sequelae in diabetic patients.
CellInsulin-Dependent Diabetes Mellitus
1,155 Citations1996Roland Tisch, Hugh O. McDevitt
Anti-α/β T cell receptor monoclonal antibody provides an efficient therapy for autoimmune diabetes in nonobese diabetic (NOD) mice and prediabetic NOD mice are protected from disease when treated with antibodies that interfere with antigen recognition.
European Heart JournalPrevention of coronary heart disease in clinical practice Recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention
1,126 Citations1998Second Joint Task Force of European
Diabetes CareScreening for type 2 diabetes.
1,033 Citations2000Michael M. Engelgau, K.M. Venkat Narayan +1 more
It will be important to use comprehensive cardiovascular disease modules that assess the conjoint influence of glucose and cardiovascular risk factor reduction, information on QOL, and refined economic evaluations using common outcome measures within economic studies to allow selection of the optimal approach within the financial and resource limitations of the health care system.
DiabetesThe Relationship of Glycemic Exposure (HbA1c) to the Risk of Development and Progression of Retinopathy in the Diabetes Control and Complications Trial
1,032 Citations1995The Diabetes Control and Complications Trial Research Group
An epidemiological assessment of the association between levels of glycemic exposure (HbA1c) before and during the DCCT with the risk of retinopathy progression within each treatment group concludes that intensive therapy with the goal of achieving near-normal glycemia should be implemented as early as possible in as many IDDM patients as is safely possible.
Trends in Food Science & TechnologyThe dietary and nutritional survey of British adults
874 Citations1990
The LancetCORONARY-HEART-DISEASE RISK AND IMPAIRED GLUCOSE TOLERANCE The Whitehall Study
794 Citations1980JohnH. Fuller, MartinJ. Shipley +3 more
In the Whitehall Study of 18,403 male civil servants aged 40--64 years, 7 1/2 year coronary-heart-disease (CHD) mortality has been examined in relation to blood-sugar concentration 2 h after a 50 g oral glucose load, and age, systolic blood-pressure, and ECG abnormality were significantly predictive of subsequent CHD mortality.
PubMedEPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer.
785 Citations1999N. E. Day, Suzy Oakes +5 more
Archives of Internal MedicineSerum Cholesterol, Blood Pressure, Cigarette Smoking, and Death From Coronary Heart Disease Overall Findings and Differences by Age for 316099 White Men
784 Citations1992James D. Neaton
Systolic and diastolic BP, serum cholesterol level, and cigarettes per day were significant predictors of death due to CHD in all age groups and offer strong support for intensified preventive efforts in allage groups.
Archives of Internal MedicineSerum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease. Overall findings and differences by age for 316,099 white men. Multiple Risk Factor Intervention Trial Research Group
683 Citations1992James D. Neaton
Systolic and diastolic BP, serum cholesterol level, and cigarettes per day were significant predictors of death due to CHD in all age groups and offer strong support for intensified preventive efforts in allage groups.
DiabetologiaHyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study
616 Citations1999Femmie de Vegt, Joost Dekker +5 more
High glycaemic variables, especially 2-h post-load glucose concentrations and to a lesser extent HbA1 c values, indicate a risk of all-cause and cardiovascular mortality in a general population without known diabetes.
BMJComparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes
488 Citations1994David McCane, Robert L. Hanson +5 more
It is suggested that determination of glycated haemoglobin or fasting plasma glucose concentrations alone may be acceptable alternatives to measuring glucose concentration two hours after challenge with 75 g glucose for the diagnosis of diabetes.
New England Journal of MedicineGlycosylated Hemoglobin and the Risk of Microalbuminuria in Patients with Insulin-Dependent Diabetes Mellitus
460 Citations1995Andrzej S. Królewski, Lori M. Laffel +3 more
The risk of microalbuminuria in patients with IDDM increases abruptly above a hemoglobin A1 value of 10.1 percent, suggesting that efforts to reduce the frequency of diabetic nephropathy should be focused on reducing hemoglobin C1 values that are above this threshold.
DiabetesThe Absence of a Glycemic Threshold for the Development of Long-Term Complications: The Perspective of the Diabetes Control and Complications Trial
452 Citations1996Diabetes Control and Complications Trial (DCCT) Research Group
Detailed prospective DCCT data do not support the conjecture that a glycemic threshold for the development of complications exists at an HbA1c level of 8% or that an HBA1C goal of 8%, and recommend implementation of intensive therapy with the goal of achieving normal glycemia as early as possible in as many IDDM patients as is safely possible.
PubMedGlucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe.
419 Citations1999
Fasting-glucose concentrations alone do not identify individuals at increased risk of death associated with hyperglycaemia, and the oral glucose tolerance test provides additional prognostic information and enables detection of individuals with impaired glucose tolerance, who have the greatest attributablerisk of death.
Acta Medica ScandinavicaPlasma Insulin as Coronary Heart Disease Risk Factor: Relationship to other Risk Factors and Predictive Value during 9½‐year Follow‐up of the Helsinki Policemen Study Population
368 Citations1985Kalevi Pyörälà, Eero Savolainen +2 more
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PubMedCoronary heart disease mortality in relation with diabetes, blood glucose and plasma insulin levels. The Paris Prospective Study, ten years later.
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It is concluded that high insulin levels may constitute a more sensitive predictor of CHD than the degree of glucose intolerance, it could be useful to avoid excessive insulin plasma concentration, and even to lower its level.
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310 Citations1987Richard P. Donahue, Robert D. Abbott +2 more
It is concluded that a continuously increasing risk gradient exists between postchallenge glucose and subsequent CHD that is independent of other known risk factors.
DiabetesAssociation of HbA1c With Prevalent Cardiovascular Disease in the Original Cohort of the Framingham Heart Study
279 Citations1992Daniel E. Singer, David M. Nathan +3 more
A strong, significant, independent association between hyperglycemia, measured by HbA1c, and CVD among older women is revealed and there was no significant relationship between “casual” blood glucose and prevalent CVD.
DiabetologiaIsolated post-challenge hyperglycaemia confirmed as a risk factor for mortality
256 Citations1999J.E. Shaw, Allison Hodge +3 more
The data show that isolated post-challenge hyperglycaemia, which can only be identified by the 2-h glucose, is common, and at least doubles the mortality risk, and should be considered in the design of screening programmes that use only fasting glucose.
Archives of Internal MedicineThe Association of Glycemia and Cause-Specific Mortality in a Diabetic Population
217 Citations1994Scot E. Moss
Results suggest possible benefit to the control of glycemia with respect to death due to vascular disease and diabetes.
The LancetCardiovascular disease in older adults with glucose disorders: comparison of American Diabetes Association criteria for diabetes mellitus with WHO criteria
197 Citations1999Joshua I. Barzilay, Charles Spiekerman +7 more
The new fasting ADA criteria seem to be less predictive than the WHO criteria for the burden of cardiovascular disease associated with abnormal glucose in the elderly.
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166 Citations1985WILLIAM J. BUTTER, Leon D. Ostrander +2 more
The coronary heart disease mortality of participants in the Tecumseh study was examined with particular emphasis on the roles of diabetes and glucose tolerance as risk factors, and the predictive power of most risk factors except age itself decreased among progressively older segments of the population.
Diabetes CareGHb Is a Better Predictor of Cardiovascular Disease Than Fasting or Postchallenge Plasma Glucose in Women Without Diabetes: The Rancho Bernardo Study
163 Citations1996Sue Park, Elizabeth Barrett‐Connor +3 more
It is concluded that GHb is a better predictor of CVD and IHD mortality than FPG or PCPG in women without diabetes; no single measure of glycemia was predictive in men.
Diabetes CareVitamin C and hyperglycemia in the European Prospective Investigation into Cancer--Norfolk (EPIC-Norfolk) study: a population-based study.
139 Citations2000L A Sargeant, Nicholas J. Wareham +6 more
Dietary measures to increase plasma vitamin C may be an important public health strategy for reducing the prevalence of diabetes and an inverse association was found between HbA1c.
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118 Citations1999Desmond E. Williams, Nicholas J. Wareham +4 more
Frequent self-reported pasta and rice consumption was associated with a reduction in the risk of having IGT and NIDDM, and whether these associations reflect specific effects of particular nutrients or are a reflection of the patterning of lifestyle factors remains to be determined.
American Journal of EpidemiologyGlucose Intolerance and Physical Inactivity: The Relative Importance of Low Habitual Energy Expenditure and Cardiorespiratory Fitness
100 Citations2000Nicholas J. Wareham, Michael Wong +1 more
The model incorporating bivariate adjustment for measurement error showed that energy expenditure had a major effect on glucose tolerance, but there was less of an effect for cardiorespiratory fitness, which provides support for public health strategies aimed at increasing overall energy expenditure.
American Journal of EpidemiologySex Differences in Fasting Glycemia as a Risk Factor for Ischemic Heart Disease Death
86 Citations1991Christa Scheidt‐Nave, Elizabeth Barrett‐Connor +3 more
Sex differences in the effect of fasting glycemia on ischemic heart disease mortality among nondiabetics exist and are unexplained, and elucidation may hold a key to the sex difference in heart disease.
Diabetic MedicineGlucose: a Continuous Risk Factor for Cardiovascular Disease
85 Citations1997Hertzel C. Gerstein
Diabetes CareGlycosylated Hemoglobin Level and Carotid Intimal-Medial Thickening in Nondiabetic Individuals: The Atherosclerosis Risk in Communities Study
73 Citations1997Lori L Vitelli, Eyal Shahar +6 more
Data provide some support to the hypothesis that in the absence of diabetes, homeostatic glycemic control is a risk factor for atherosclerosis, as modeled linearly as a continuous variable and after adjustment for the above-mentioned covariates.
BMJStrategy of prevention: lessons from cardiovascular disease.
72 Citations1981Geoffrey Rose, J Mann
The authors claim that their study demonstrates the effectiveness of treatment in mild hypertension and shows that the benefits of treatment outweigh the costs and the evidence as presented is insufficient to justify these claims.
Archives of Internal MedicineThe association of glycemia and cause-specific mortality in a diabetic population
61 Citations1994S. E. Moss
Diabetic MedicineFasting Blood Glucose and Risk of Coronary Heart Disease, Stroke, and All‐cause Mortality: A 17‐year Follow‐up Study of Men Born in 1913
36 Citations1986L.‐O. Ohlson, Kurt Svärdsudd +5 more
When quintiles and deciles of the FBG distribution were considered, no trend of 17‐year incidence of CHD, stroke or death was apparent, but for men with an FBG above the 95th percentile (>5.7 mmol/l) a non‐significant trend towards increasing risk was indicated.
PubMed[Definition, diagnosis, and classification of lupus].
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Clinical variants of lupus erythematosus are numerous such as initial clinical manifestations; epidemiological considerations have shown different subsets with different manifestations depending on ethnicity, age at first symptoms, environmental factors, and genetic background influences the autoantibody profile.