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Haemoglobin glycation index and risk for diabetes-related complications in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial

Previous studies have suggested that the haemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications in individuals with type 1 and type 2 diabetes. We investigated whether HGI was a predictor of adverse outcomes of intensive glucose lowering and of diabetes-relate... Full description

Journal Title: Diabetologia 2018, Vol.61 (4), p.780-789
Main Author: van Steen, Sigrid C
Other Authors: Woodward, Mark , Chalmers, John , Li, Qiang , Marre, Michel , Cooper, Mark E , Hamet, Pavel , Mancia, Giuseppe , Colagiuri, Stephen , Williams, Bryan , Grobbee, Diederick E , DeVries, J. Hans
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0012-186X
Link: https://www.ncbi.nlm.nih.gov/pubmed/29308539
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recordid: cdi_pubmed_primary_29308539
title: Haemoglobin glycation index and risk for diabetes-related complications in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial
format: Article
creator:
  • van Steen, Sigrid C
  • Woodward, Mark
  • Chalmers, John
  • Li, Qiang
  • Marre, Michel
  • Cooper, Mark E
  • Hamet, Pavel
  • Mancia, Giuseppe
  • Colagiuri, Stephen
  • Williams, Bryan
  • Grobbee, Diederick E
  • DeVries, J. Hans
subjects:
  • (Blood) glucose
  • Aged
  • Antihypertensive Agents - administration & dosage
  • Article
  • Blood circulation disorders
  • Cardiovascular complications
  • Complications and side effects
  • Diabetes Complications - blood
  • Diabetes Complications - drug therapy
  • Diabetes mellitus
  • Diabetes mellitus, type 2
  • Diabetes Mellitus, Type 2 - blood
  • Diabetes Mellitus, Type 2 - complications
  • Diabetes Mellitus, Type 2 - drug therapy
  • Diabetes therapy
  • Drug Combinations
  • endocrine system diseases
  • Female
  • Gliclazide - administration & dosage
  • Glycosylation
  • HbA 1c
  • HbA1c
  • Hemoglobin
  • Hemoglobins - analysis
  • Human Physiology
  • Humans
  • Hypoglycaemia
  • Hypoglycemic Agents - administration & dosage
  • Indapamide - administration & dosage
  • Internal Medicine
  • Male
  • Medicine
  • Medicine & Public Health
  • Metabolic Diseases
  • Microcirculation
  • Middle Aged
  • Mortality
  • nutritional
  • Perindopril - administration & dosage
  • Proportional Hazards Models
  • Risk
  • Risk factors
  • Treatment Outcome
  • type 2
  • Type 2 diabetes
  • Vascular Diseases - blood
  • Vascular Diseases - complications
  • Vascular Diseases - drug therapy
ispartof: Diabetologia, 2018, Vol.61 (4), p.780-789
description: Previous studies have suggested that the haemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications in individuals with type 1 and type 2 diabetes. We investigated whether HGI was a predictor of adverse outcomes of intensive glucose lowering and of diabetes-related complications in general, using data from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. We studied participants in the ADVANCE trial with data available for baseline HbA1c and fasting plasma glucose (FPG) (n = 11,083). HGI is the difference between observed HbA1c and HbA1c predicted from a simple linear regression of HbA1c on FPG. Using Cox regression, we investigated the association between HGI, both categorised and continuous, and adverse outcomes, considering treatment allocation (intensive or standard glucose control) and compared prediction of HGI and HbA1c. Intensive glucose control lowered mortality risk in individuals with high HGI only (HR 0.74 [95% CI 0.61, 0.91]; p = 0.003), while there was no difference in the effect of intensive treatment on mortality in those with high HbA1c. Irrespective of treatment allocation, every SD increase in HGI was associated with a significant risk increase of 14-17% for macrovascular and microvascular disease and mortality. However, when adjusted for identical covariates, HbA1c was a stronger predictor of these outcomes than HGI. HGI predicts risk for complications in ADVANCE participants, irrespective of treatment allocation, but no better than HbA1c. Individuals with high HGI have a lower risk for mortality when on intensive treatment. Given the discordant results and uncertain relevance beyond HbA1c, clinical use of HGI in type 2 diabetes cannot currently be recommended
language: eng
source:
identifier: ISSN: 0012-186X
fulltext: no_fulltext
issn:
  • 0012-186X
  • 1432-0428
  • 1432-0428
  • 0012-186X
url: Link


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titleHaemoglobin glycation index and risk for diabetes-related complications in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial
creatorvan Steen, Sigrid C ; Woodward, Mark ; Chalmers, John ; Li, Qiang ; Marre, Michel ; Cooper, Mark E ; Hamet, Pavel ; Mancia, Giuseppe ; Colagiuri, Stephen ; Williams, Bryan ; Grobbee, Diederick E ; DeVries, J. Hans
creatorcontribvan Steen, Sigrid C ; Woodward, Mark ; Chalmers, John ; Li, Qiang ; Marre, Michel ; Cooper, Mark E ; Hamet, Pavel ; Mancia, Giuseppe ; Colagiuri, Stephen ; Williams, Bryan ; Grobbee, Diederick E ; DeVries, J. Hans ; ADVANCE Collaborative Group ; on behalf of the ADVANCE Collaborative Group
descriptionPrevious studies have suggested that the haemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications in individuals with type 1 and type 2 diabetes. We investigated whether HGI was a predictor of adverse outcomes of intensive glucose lowering and of diabetes-related complications in general, using data from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. We studied participants in the ADVANCE trial with data available for baseline HbA1c and fasting plasma glucose (FPG) (n = 11,083). HGI is the difference between observed HbA1c and HbA1c predicted from a simple linear regression of HbA1c on FPG. Using Cox regression, we investigated the association between HGI, both categorised and continuous, and adverse outcomes, considering treatment allocation (intensive or standard glucose control) and compared prediction of HGI and HbA1c. Intensive glucose control lowered mortality risk in individuals with high HGI only (HR 0.74 [95% CI 0.61, 0.91]; p = 0.003), while there was no difference in the effect of intensive treatment on mortality in those with high HbA1c. Irrespective of treatment allocation, every SD increase in HGI was associated with a significant risk increase of 14-17% for macrovascular and microvascular disease and mortality. However, when adjusted for identical covariates, HbA1c was a stronger predictor of these outcomes than HGI. HGI predicts risk for complications in ADVANCE participants, irrespective of treatment allocation, but no better than HbA1c. Individuals with high HGI have a lower risk for mortality when on intensive treatment. Given the discordant results and uncertain relevance beyond HbA1c, clinical use of HGI in type 2 diabetes cannot currently be recommended
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descriptionPrevious studies have suggested that the haemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications in individuals with type 1 and type 2 diabetes. We investigated whether HGI was a predictor of adverse outcomes of intensive glucose lowering and of diabetes-related complications in general, using data from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. We studied participants in the ADVANCE trial with data available for baseline HbA1c and fasting plasma glucose (FPG) (n = 11,083). HGI is the difference between observed HbA1c and HbA1c predicted from a simple linear regression of HbA1c on FPG. Using Cox regression, we investigated the association between HGI, both categorised and continuous, and adverse outcomes, considering treatment allocation (intensive or standard glucose control) and compared prediction of HGI and HbA1c. Intensive glucose control lowered mortality risk in individuals with high HGI only (HR 0.74 [95% CI 0.61, 0.91]; p = 0.003), while there was no difference in the effect of intensive treatment on mortality in those with high HbA1c. Irrespective of treatment allocation, every SD increase in HGI was associated with a significant risk increase of 14-17% for macrovascular and microvascular disease and mortality. However, when adjusted for identical covariates, HbA1c was a stronger predictor of these outcomes than HGI. HGI predicts risk for complications in ADVANCE participants, irrespective of treatment allocation, but no better than HbA1c. Individuals with high HGI have a lower risk for mortality when on intensive treatment. Given the discordant results and uncertain relevance beyond HbA1c, clinical use of HGI in type 2 diabetes cannot currently be recommended
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16endocrine system diseases
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24Human Physiology
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27Hypoglycemic Agents - administration & dosage
28Indapamide - administration & dosage
29Internal Medicine
30Male
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32Medicine & Public Health
33Metabolic Diseases
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35Middle Aged
36Mortality
37nutritional
38Perindopril - administration & dosage
39Proportional Hazards Models
40Risk
41Risk factors
42Treatment Outcome
43type 2
44Type 2 diabetes
45Vascular Diseases - blood
46Vascular Diseases - complications
47Vascular Diseases - drug therapy
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titleHaemoglobin glycation index and risk for diabetes-related complications in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial
authorvan Steen, Sigrid C ; Woodward, Mark ; Chalmers, John ; Li, Qiang ; Marre, Michel ; Cooper, Mark E ; Hamet, Pavel ; Mancia, Giuseppe ; Colagiuri, Stephen ; Williams, Bryan ; Grobbee, Diederick E ; DeVries, J. Hans
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0(Blood) glucose
1Aged
2Antihypertensive Agents - administration & dosage
3Article
4Blood circulation disorders
5Cardiovascular complications
6Complications and side effects
7Diabetes Complications - blood
8Diabetes Complications - drug therapy
9Diabetes mellitus
10Diabetes mellitus, type 2
11Diabetes Mellitus, Type 2 - blood
12Diabetes Mellitus, Type 2 - complications
13Diabetes Mellitus, Type 2 - drug therapy
14Diabetes therapy
15Drug Combinations
16endocrine system diseases
17Female
18Gliclazide - administration & dosage
19Glycosylation
20HbA 1c
21HbA1c
22Hemoglobin
23Hemoglobins - analysis
24Human Physiology
25Humans
26Hypoglycaemia
27Hypoglycemic Agents - administration & dosage
28Indapamide - administration & dosage
29Internal Medicine
30Male
31Medicine
32Medicine & Public Health
33Metabolic Diseases
34Microcirculation
35Middle Aged
36Mortality
37nutritional
38Perindopril - administration & dosage
39Proportional Hazards Models
40Risk
41Risk factors
42Treatment Outcome
43type 2
44Type 2 diabetes
45Vascular Diseases - blood
46Vascular Diseases - complications
47Vascular Diseases - drug therapy
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1Woodward, Mark
2Chalmers, John
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9Williams, Bryan
10Grobbee, Diederick E
11DeVries, J. Hans
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abstractPrevious studies have suggested that the haemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications in individuals with type 1 and type 2 diabetes. We investigated whether HGI was a predictor of adverse outcomes of intensive glucose lowering and of diabetes-related complications in general, using data from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. We studied participants in the ADVANCE trial with data available for baseline HbA1c and fasting plasma glucose (FPG) (n = 11,083). HGI is the difference between observed HbA1c and HbA1c predicted from a simple linear regression of HbA1c on FPG. Using Cox regression, we investigated the association between HGI, both categorised and continuous, and adverse outcomes, considering treatment allocation (intensive or standard glucose control) and compared prediction of HGI and HbA1c. Intensive glucose control lowered mortality risk in individuals with high HGI only (HR 0.74 [95% CI 0.61, 0.91]; p = 0.003), while there was no difference in the effect of intensive treatment on mortality in those with high HbA1c. Irrespective of treatment allocation, every SD increase in HGI was associated with a significant risk increase of 14-17% for macrovascular and microvascular disease and mortality. However, when adjusted for identical covariates, HbA1c was a stronger predictor of these outcomes than HGI. HGI predicts risk for complications in ADVANCE participants, irrespective of treatment allocation, but no better than HbA1c. Individuals with high HGI have a lower risk for mortality when on intensive treatment. Given the discordant results and uncertain relevance beyond HbA1c, clinical use of HGI in type 2 diabetes cannot currently be recommended
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid29308539
doi10.1007/s00125-017-4539-1
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