To Study relation of HbA1c with cardiovascular disease risk factors in non- diabetic subjects of Northern-India having coronary artery diseases (original) (raw)

The objective is to study relation of HbA1c with cardiovascular disease risk factors in non-diabetic subjects of Northern-India having coronary artery diseases. This hospital based analytic-cross sectional study was conducted in department of medicine at a tertiary care center in Northern-India during the period of March-July, 2012 among 69 admitted cases of CAD. Patients with CAD and had HbA1c 4-6.4 %, FPG< 100 mg/dL (< 5.55 mmol/L) or PPPG< 140 mg/dL(7.77 mmol/L) were included in this study. Patients who had diabetes, acute febrile illness, anemia (Hb< 10 g/dL in female &< 12 g/dL in male), hemoglobinopathy and who did not give informed consent were excluded from the study. CAD was defined based on documented history of myocardial infarction or ECG criteria as per Minnesota codes. Special INTERHEART questionnaires were being used for physical activity and dietary habits. A detail history and clinical examination was carried out. HbA1c was measured by chromatography analyzer (Turbidimetric HPLC method). BMI, WC, serum TC, TG, and LDL increased significantly with higher tertiles of HbA1c similar to known cardiovascular risk factors viz. family H/O premature CAD, dyslipidemia (high TG & low HDL) and obesity, especially, central type(P for trend < 0.05).The mean ± SD HbA1c value in the study cohort was 5.39 ± 0.78%. Mean HbA1c differed statistically significantly in subjects having unhealthy diet, obesity (including central type) and hypertriglyceridemia (p < 0.05). HbA1c had significant correlation with BMI (r=+0.429, p=0.0002), WC (r=+0.4311, p=0.0002), FPG (r=+0.394, p=0.0008), TG (r=+0.4151, p=0.0004), TC (r=+0.356, p=0.0027), LDL (r=+0.290, p=0.0168), and VLDL (r=+ 0.4101, p=0.0005). On multivariate analysis, BMI (β=+0.05, p=0.007) and FPG (β=+0.04, p=0.000) were significantly correlated. When separate correlation was done with FPG as dependent variable, no risk factors were significantly correlated. In non-diabetic CAD patients, HbA1c showed significant association with CVD risk factors i.e. obesity including central type and dyslipidemia (especially hypertriglyceridemia), typical of Asian Indian phenotype. Therefore, HbA1c might be a useful measure even among the non-diabetic population in assessing an individual's cardiovascular risk.