Glycemic Control and Cardiovascular Disease in 7,454 Patients With Type 1 Diabetes An observational study from the Swedish National Diabetes Register (NDR)
(2010) In Diabetes Care 33(7). p.1640-1646- Abstract
- OBJECTIVE - We assessed the association between A1C and cardiovascular diseases (CVDs) in an observational study of patients with type 1 diabetes followed for 5 years. RESEARCH DESIGN AND METHODS - A total of 7,454 patients were studied from the Swedish National Diabetes Register (aged 20-65 years, diabetes duration 1-35 years, followed from 2002 to 2007). RESULTS - Hazard ratios (HRs) for fatal/nonfatal coronary heart disease (CHD) per 1% unit increase in baseline or updated mean A1C at Cox regression analysis were 1.31 and 1.34 and 1.26 and 1.32, respectively, for fatal/nonfatal CVD (all P < 0.001 after adjustment for age, sex, diabetes duration, blood pressure, total and LDL cholesterol, triglycerides, BMI, smoking, and history of... (More)
- OBJECTIVE - We assessed the association between A1C and cardiovascular diseases (CVDs) in an observational study of patients with type 1 diabetes followed for 5 years. RESEARCH DESIGN AND METHODS - A total of 7,454 patients were studied from the Swedish National Diabetes Register (aged 20-65 years, diabetes duration 1-35 years, followed from 2002 to 2007). RESULTS - Hazard ratios (HRs) for fatal/nonfatal coronary heart disease (CHD) per 1% unit increase in baseline or updated mean A1C at Cox regression analysis were 1.31 and 1.34 and 1.26 and 1.32, respectively, for fatal/nonfatal CVD (all P < 0.001 after adjustment for age, sex, diabetes duration, blood pressure, total and LDL cholesterol, triglycerides, BMI, smoking, and history of CVD). HRs were only slightly lower for CHD (P = 0.002) and CVD (P = 0.002-0.007) after also adjusting for albuminuria. Adjusted 5-year event rates of CHD and CVD increased progressively with higher A1C, ranging from 5 to 12%, as well as when subgrouped by shorter (1-20 years) or longer (21-35 years) duration of diabetes. A group of 4,186 patients with A1C 5-7.9% (mean 7.2) at baseline showed risk reductions of 41% (95% confidence intervals: 15-60) (P = 0.005) for fatal/nonfatal CHD and 37% (12-55) (P = 0.008) for CVD, compared with 3,268 patients with A1C 8-11.9% (mean 9.0), fully adjusted also for albuminuria. CONCLUSIONS - This observational study of patients in modem everyday clinical practice demonstrates progressively increasing risks for CHD and CVD with higher A1C, independently of traditional risk factors, with no J-shaped risk curves. A baseline mean A1C of 7.2% showed considerably reduced risks of CHD and CVD compared with A1C 9.0%, emphasizing A1C as a strong independent risk factor in type 1 diabetes. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1727922
- author
- Eeg-Olofsson, Katarina ; Cederholm, Jan ; Nilsson, Peter LU ; Zethelius, Bjorn ; Svensson, Ann-Marie ; Gudbjornsdottir, Soffia and Eliasson, Bjorn
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Diabetes Care
- volume
- 33
- issue
- 7
- pages
- 1640 - 1646
- publisher
- American Diabetes Association
- external identifiers
-
- wos:000282356800045
- scopus:77958190476
- pmid:20424222
- ISSN
- 1935-5548
- DOI
- 10.2337/dc10-0398
- language
- English
- LU publication?
- yes
- id
- 8ec14686-475a-4e73-97c5-ca8d6a3eb619 (old id 1727922)
- date added to LUP
- 2016-04-01 13:11:30
- date last changed
- 2022-03-13 22:40:04
@article{8ec14686-475a-4e73-97c5-ca8d6a3eb619,
abstract = {{OBJECTIVE - We assessed the association between A1C and cardiovascular diseases (CVDs) in an observational study of patients with type 1 diabetes followed for 5 years. RESEARCH DESIGN AND METHODS - A total of 7,454 patients were studied from the Swedish National Diabetes Register (aged 20-65 years, diabetes duration 1-35 years, followed from 2002 to 2007). RESULTS - Hazard ratios (HRs) for fatal/nonfatal coronary heart disease (CHD) per 1% unit increase in baseline or updated mean A1C at Cox regression analysis were 1.31 and 1.34 and 1.26 and 1.32, respectively, for fatal/nonfatal CVD (all P < 0.001 after adjustment for age, sex, diabetes duration, blood pressure, total and LDL cholesterol, triglycerides, BMI, smoking, and history of CVD). HRs were only slightly lower for CHD (P = 0.002) and CVD (P = 0.002-0.007) after also adjusting for albuminuria. Adjusted 5-year event rates of CHD and CVD increased progressively with higher A1C, ranging from 5 to 12%, as well as when subgrouped by shorter (1-20 years) or longer (21-35 years) duration of diabetes. A group of 4,186 patients with A1C 5-7.9% (mean 7.2) at baseline showed risk reductions of 41% (95% confidence intervals: 15-60) (P = 0.005) for fatal/nonfatal CHD and 37% (12-55) (P = 0.008) for CVD, compared with 3,268 patients with A1C 8-11.9% (mean 9.0), fully adjusted also for albuminuria. CONCLUSIONS - This observational study of patients in modem everyday clinical practice demonstrates progressively increasing risks for CHD and CVD with higher A1C, independently of traditional risk factors, with no J-shaped risk curves. A baseline mean A1C of 7.2% showed considerably reduced risks of CHD and CVD compared with A1C 9.0%, emphasizing A1C as a strong independent risk factor in type 1 diabetes.}},
author = {{Eeg-Olofsson, Katarina and Cederholm, Jan and Nilsson, Peter and Zethelius, Bjorn and Svensson, Ann-Marie and Gudbjornsdottir, Soffia and Eliasson, Bjorn}},
issn = {{1935-5548}},
language = {{eng}},
number = {{7}},
pages = {{1640--1646}},
publisher = {{American Diabetes Association}},
series = {{Diabetes Care}},
title = {{Glycemic Control and Cardiovascular Disease in 7,454 Patients With Type 1 Diabetes An observational study from the Swedish National Diabetes Register (NDR)}},
url = {{http://dx.doi.org/10.2337/dc10-0398}},
doi = {{10.2337/dc10-0398}},
volume = {{33}},
year = {{2010}},
}