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PMID: 17768606 Published · ppublish English Journal Article Research Support, N.I.H., Extramural

Changes in glycaemic control and risk of coronary artery disease in type 1 diabetes mellitus: findings from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC).

Diabetologia ·Vol. 50 ·No. 11 ·2007-11-00 ·Pages 2280-8

Prince CT, Becker DJ, Costacou T, Miller RG, Orchard TJ

Abstract

To complete a comparative analysis of studies that have examined the relationship between glycaemia and cardiovascular disease (CVD)/coronary artery disease (CAD) and perform a prospective analysis of the effect of change in glycosylated Hb level on CAD risk in the Pittsburgh Epidemiology of Diabetes Complications Study (EDC) of childhood-onset type 1 diabetes mellitus (n = 469) over 16 years of two yearly follow-up. Measured values for HbA(1) and HbA(1c) from the EDC were converted to the DCCT-standard HbA(1c) for change analyses and the change in HbA(1c) was calculated (final HbA(1c) minus baseline HbA(1c)). CAD was defined as EDC-diagnosed angina, myocardial infarction, ischaemia, revascularisation or fatal CAD after medical record review. The comparative analysis suggested that glycaemia may have a stronger effect on CAD in patients without, than in those with, albuminuria. In EDC, the change in HbA(1c) differed significantly between CAD cases (+0.62 +/- 1.8%) and non-cases (-0.09 +/- 1.9%) and was an independent predictor of CAD. Discrepant study results regarding the relationship of glycaemia with CVD/CAD may, in part, be related to the prevalence of renal disease. Measures of HbA(1c) change over time show a stronger association with CAD than baseline values.

MeSH Terms
Adult Blood Glucose/metabolism Body Mass Index Coronary Disease/epidemiology Diabetes Mellitus, Type 1/blood,complications Diabetic Angiopathies/epidemiology Female Glycated Hemoglobin A/metabolism Humans Incidence Male Middle Aged Pennsylvania Risk Factors
Chemicals
Blood Glucose Glycated Hemoglobin A
Authors & Affiliations
5 authors, click to expand affiliations / ORCID
Prince C T
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, 3512 Fifth Avenue, Second Floor, Pittsburgh, PA 15213, USA.
Becker D J
Costacou T
Miller R G
Orchard T J
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Article Info
Journal
Diabetologia
Abbr.
Diabetologia
ISSN
0012-186X
DOI
10.1007/s00125-007-0797-7
Published
2007-11-00
Epub
2007-00-02
Pages
2280-8
Language
English
Region
Germany
NLM ID
0006777
Subset
IM
Grants
NCATS NIH HHS · UL1 TR000005 · United States
PHS HHS · NIH/NIDDK 34818 · United States
External Links
PubMed source DOI: 10.1007/s00125-007-0797-7 View journal details
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