Original article
Tracking of glycated hemoglobin in the original cohort of the framingham heart study

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Abstract

Glycated hemoglobin measures average blood glucose over the preceding 2 to 3 months. The authors examined the tracking of the major glycated hemoglobin, hemoglobin A1c (HbA1c), over a period of 4 to 6 years. Two HbA1c measurements were obtained between 1986 and 1993 from 639 elderly, presumptively nondiabetic members of the original cohort of the Framingham Heart Study, Framingham, Massachusetts. Mean ± standard deviation (SD) baseline and follow-up HbA1c were 5.43% ± 0.7 and 5.71% ± 0.9, respectively. Intraclass correlation of 0.59 between baseline and follow-up measurements indicated good reliability of a single HbA1c measurement. Ninety-one percent of follow-up measurements were within ±20% of baseline value; HbA1c values tended to move 15% closer to the baseline mean over time. There was a modest tendency for HbA1c values to increase with time; the mean difference between measurements was 0.28% ± 0.7 SD (p < 0.0001). Change in HbA1c was positively associated with age and body mass index at baseline examination, and negatively associated with cigarette smoking, even after controlling for age and body mass index. These effects were very small, however. We conclude that glycated hemoglobin reliably categorizes the glucose control of nondiabetic subjects over a period of 4 to 6 years, confirming its value as an epidemiological measure.

Keywords

Blood glucose
epidemiological factors
HBA1c
hemoglobin A-glycosylated
longitudinal study

Cited by (0)

1

James B. Meigs was supported by a training grant for Faculty Development in General Internal Medicine at Harvard Medical School from the Department of Health and Human Services, Public Health Service (2 T32 PE11001-06).

3

David M. Nathan was supported in part by a subcontract from the Framingham Study.

4

L. Adrienne Cupples was supported in party by Framingham contract form NOI-HC-38038, National Heart, Lung, and Blood Institute.

2

Daniel E. Singer was supported in part by a Henry J. Kaiser Family Foundation Scholar Award in General Internal Medicine, and in part by a subcontract from the Framingham Study.