HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans

P. Jordan Davis, Mengling Liu, Scott Sherman, Sundar Natarajan, Farrokh Alemi, Ashley Jensen, Sanja Avramovic, Mark D. Schwartz, Richard B. Hayes

Research output: Contribution to journalArticle

Abstract

United States Veterans are at excess risk for type 2 diabetes, but population differentials in risk have not been characterized. We determined risk of type 2 diabetes in relation to prediabetes and dyslipidemic profiles in Veterans at the VA New York Harbor (VA NYHHS) during 2004–2014. Prediabetes was based on American Diabetes Association hemoglobin A1c (HbA1c) testing cut-points, one of several possible criteria used to define prediabetes. We evaluated transition to type 2 diabetes in 4,297 normoglycemic Veterans and 7,060 Veterans with prediabetes. Cox proportional hazards regression was used to relate HbA1c levels, lipid profiles, demographic, anthropometric and comorbid cardiovascular factors to incident diabetes (Hazard Ratio [HR] and 95% confidence intervals). Compared to normoglycemic Veterans (HbA1c: 5.0–5.6%; 31–38 mmol/mol), risks for diabetes were >2-fold in the moderate prediabetes risk group (HbA1c: 5.7–5.9%; 39–41 mmol/mol) (HR 2.37 [1.98–2.85]) and >5-fold in the high risk prediabetes group (HbA1c: 6.0–6.4%; 42–46 mmol/mol) (HR 5.59 [4.75–6.58]). Risks for diabetes were increased with elevated VLDL (40mg/dl; HR 1.31 [1.09–1.58]) and TG/HDL (1.5mg/dl; HR 1.34 [1.12–1.59]), and decreased with elevated HDL (35mg/dl; HR 0.80 [0.67–0.96]). Transition to diabetes in Veterans was related in age-stratified risk score analyses to HbA1c, VLDL, HDL and TG/HDL, BMI, hypertension and race, with 5-year risk differentials of 62% for the lowest (5-year risk, 13.5%) vs. the highest quartile (5-year risk, 21.9%) of the risk score. This investigation identified substantial differentials in risk of diabetes in Veterans, based on a readily-derived risk score suitable for risk stratification for type 2 diabetes prevention.

Original languageEnglish (US)
Article numbere0203484
JournalPLoS One
Volume13
Issue number9
DOIs
StatePublished - Sep 1 2018

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veterans
glycohemoglobin
Veterans
Medical problems
noninsulin-dependent diabetes mellitus
Type 2 Diabetes Mellitus
Hemoglobins
Lipids
Prediabetic State
lipids
Hazards
diabetes
risk groups
hypertension
Ports and harbors

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Jordan Davis, P., Liu, M., Sherman, S., Natarajan, S., Alemi, F., Jensen, A., ... Hayes, R. B. (2018). HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans. PLoS One, 13(9), [e0203484]. https://doi.org/10.1371/journal.pone.0203484

HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans. / Jordan Davis, P.; Liu, Mengling; Sherman, Scott; Natarajan, Sundar; Alemi, Farrokh; Jensen, Ashley; Avramovic, Sanja; Schwartz, Mark D.; Hayes, Richard B.

In: PLoS One, Vol. 13, No. 9, e0203484, 01.09.2018.

Research output: Contribution to journalArticle

Jordan Davis, P, Liu, M, Sherman, S, Natarajan, S, Alemi, F, Jensen, A, Avramovic, S, Schwartz, MD & Hayes, RB 2018, 'HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans', PLoS One, vol. 13, no. 9, e0203484. https://doi.org/10.1371/journal.pone.0203484
Jordan Davis, P. ; Liu, Mengling ; Sherman, Scott ; Natarajan, Sundar ; Alemi, Farrokh ; Jensen, Ashley ; Avramovic, Sanja ; Schwartz, Mark D. ; Hayes, Richard B. / HbA1c, lipid profiles and risk of incident type 2 Diabetes in United States Veterans. In: PLoS One. 2018 ; Vol. 13, No. 9.
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