Browse > Article
http://dx.doi.org/10.5393/JAMCH.2012.37.4.215

Association of Hemoglobin A1c with Visceral Fat Measured by Computed Tomography in Nondiabetic Adults  

Han, A Lum (Department of Family Medicine, Hospital of Wonkwang University)
Shin, Sae-Ron (Department of Family Medicine, Hospital of Wonkwang University)
Park, Seong-Hoon (Department of Radiology Medicine, Hospital of Wonkwang University)
Lee, Jeong Mi (Department of Public Health, Wonkwang University Graduate School)
Publication Information
Journal of agricultural medicine and community health / v.37, no.4, 2012 , pp. 215-222 More about this Journal
Abstract
Objective: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%-6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. Methods: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was ${\geq}5.7%$ or <5.7%. Lipid levels, blood pressure, BMI (kg/$m^2$), total abdominal, and visceral fat levels were measured by computed tomography. Results: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, $6.03{\pm}0.82%$ and $5.88{\pm}0.72%$(p<0.05). Only the mean values of age and visceral fat area were different between $HbA1c{\geq}5.7%$ and <5.7% in both male and female group(p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c ${\geq}5.7%$ (odds ratio=1.005, 95% CI 1.002~1.008). Conclusions: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is ${\geq}5.7%$. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs.
Keywords
Hemoglobin A1c; Visceral fat; Prediabetes;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Lee YS, Moon SS. The use of HbA1c for diagnosis of type 2 diabetes in Korea. Korean J Med 2011 Mar;80(3):291-297 (Korean)
2 Nathan MD, Davidson MB, DeFronzo RA, Heine RJ, Pratley R, Zinman B. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007; 30:753-759   DOI   ScienceOn
3 Santaguida PL, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Y azdi H. Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose. AHRQ Study 2006;128:1-12
4 Levitan EB, Song Y, Ford ES, Liu S Is non-diabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med 2004; 164:2147-2155   DOI   ScienceOn
5 International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care July 2009 vol. 32 no. 7 1327-1334   DOI   ScienceOn
6 Eldin WS, Emara M, Shoker A. Prediabetes: a must to recognise disease state. Int J Clin Pract 2008;62:642-648   DOI   ScienceOn
7 Despres JP. Is visceral obesity the cause of the metabolic syndrome? Ann Med 2006;38: 52-63   DOI
8 Matsuzawa Y. Therapy insight: adipocytokines in metabolic syndrome and related cardiovascular disease. Nat Clin Pract Cardiovasc Med 2006;3:35-42   DOI
9 Jae Ryoung Seo, San Soo Bae. The Effect of Metabolic Syndrome Management Program in a Public Health Center. J Agric Med Community Health 2011:36(4):264-279 (Korean)   과학기술학회마을   DOI   ScienceOn
10 SjostromL, Kvist H, Cederblad A, Tyle'n U. Determination of total adipose tissue and body fat in women by computed tomography, 40K and tritium. Am J Physiol 1986:250: E736-745
11 Lemieux S, Tremblay A, Prud-Homme D, Bouchard C, Nadeau A, Despres JP. Sevenyear changes in body fat and visceral adipose tissue in women: associations with indexes of plasma glucose-insulin homeostasis. Diabetes Care 1996;19:983-991   DOI
12 Yates AP, Laing I. Age-related increase in haemoglobin A1c and fasting plasma glucose is accompanied by a decrease in $\beta$ cell function without change in insulin sensitivity: evidence from a cross-sectional study of hospital personnel. Diabet Med 2002;19:254-258   DOI
13 Mori Y, Hoshino K, Yokota K, Itoh Y, Tajima N. Differences in the pathology of the metabolic syndrome with or without visceral fat accumulation: a study in pre-diabetic Japanese middle-aged men. Endocrine 2006;29:149-153   DOI
14 Jazet IM, Pijl H, Meinders AE. Adipose tissue as an endocrine organ: impact on insulin resistance. Neth J Med 2003; 61:194-212
15 Haffner SM, Miettinen H, Gaskill SP, Stern MP. Decreased Insulin secretion and increased insulin resistance are independently related to the 7-year risk of NIDDM in Mexican- American. Diabetes 1995;44:1386-1391   DOI
16 Avogaro A. Insulin resistance: trigger or concomitant factor in the metabolic syndrome. Panminerva Med 2006;48:3-12
17 Abdul-Ghani MA, DeFronzo RA. Pathophysiology of prediabetes. Curr Diab Rep 2009;9:193-199   DOI   ScienceOn
18 Basat O, Ucak S, Ozkurt H, Basak M, Seber S, Altuntas Y. Visceral adipose tissue as an indicator of insulin resistance in nonobese patients with new onset type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2006 Feb;114(2):58-62   DOI
19 Taniguchi A, Nakai Y, Sakai M, Yoshii S, Hamanaka D, Hatae Y, Kawata M, Yamanouchi K, Okumura T, Doi K, Tokuyama K, Nagasaka S, Fukushima M. Relationship of regional adiposity to insulin resistance and serum triglyceride levels in nonobese Japanese type 2 diabetic patients. Metabolism 2002 May;51(5):544-548   DOI   ScienceOn
20 Yeo SE, Hays NP, Dennis RA, Kortebein PM, Sullivan DH, Evans WJ, Coker RH. Fat distribution and glucose metabolism in older, obese men and women. J Gerontol A Biol Sci Med Sci 2007 Dec;62(12):1393-1401   DOI
21 Kilpatrick ES, Dominiczak MH, Small M. The effects of ageing on glycation and the interpretation of glycaemic control in type 2 diabetes. Q J Med 1996;89:307-312   DOI
22 Brewer N, Wright CS, Travier N, et al. A New Zealand linkage study examining the associations between A1C concentration and mortality. Diabetes Care 2008:31:1144-1149   DOI
23 Khaw KT, Wareham N, Bingham S, Luben R, Welch A, Day N. Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European prospective investigation into cancer in Norfolk. Ann Intern Med 2004;141:413-420   DOI   ScienceOn
24 Gerstein HC, Swedberg K, Carlsson J, et al. The hemoglobin A1c level as a progressive risk factor for cardiovascular death, hospitalization for heart failure, or death in patients with chronic heart failure: an analysis of the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program. Arch Intern Med 2008;168:1699-1704   DOI
25 Levitan EB, Liu S, Stampfer MJ, et al. HbA1c measured in stored erythrocytes and mortality rate among middle-aged and older women. Diabetologia 2008;51:267-275   DOI
26 Pradhan AD, Rifai N, Buring JE, Ridker PM. Hemoglobin A1c predicts diabetes but not cardiovascular disease in nondiabetic women. Am J Med 2007;120:720-727   DOI   ScienceOn
27 Stout RL, Fulks M, Dolan VF, Magee ME, Suarez L. Relationship of hemoglobin A1c to mortality in nonsmoking insurance applicants. J Insur Med 2007;39:174-181
28 Blake GJ, Pradhan AD, Manson JE, et al. Hemoglobin A1c level and future cardiovascular events among women. Arch Intern Med 2004;164:757-761   DOI