Evidence mapPaperPMID 39551840Full record

ArticleScientific reports2024

U-shaped association between HbA1c and all-cause mortality in CVD patients with diabetes.

Jianhong Yu, Haodong Hua, Minggang Yin

Abstract read
In one paragraph

Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Review
  16. HbA1c as an Independent Predictor of Peripheral Artery Disease: Nonlinear Threshold and Causal Evidence from NHANES and Mendelian Randomization.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Jianhong YuDepartment of Clinical Laboratory, Zigong First People's Hospital, Zigong, China.
Haodong HuaDepartment of Clinical Laboratory, Zigong First People's Hospital, Zigong, China.
Minggang YinDepartment of Clinical Laboratory, Zigong First People's Hospital, Zigong, China. ymg1973@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In this analysis, the association of baseline glycated hemoglobin (HbA1c) levels with all-cause mortality in cardiovascular disease (CVD) patients with diabetes was investigated using data from NHANES 1999-2014. Under examination were 845 CVD patients who had diabetes and were followed for a median follow-up of 7.3 years, and an all-cause mortality rate of 22.60% was observed. To examine the association between HbA1c and mortality, multivariable Cox proportional hazard models using spline models determined the non-linear association. HbA1c as a continuous variable was not associated with mortality. However, a significant association was observed when HbA1c was classified according to quartiles. Particularly, after adjustment for potential confounders, in comparison to participants with HbA1c levels below 6.2%, patients with HbA1c levels of 6.2-6.8% and 6.9-7.6% had lower risks of all-cause mortality (hazard ratio: 0.49, 95% CI: 0.30-0.80 and hazard ratio: 0.64, 95% CI: 0.39-1.03, respectively). Using restricted cubic splines, further testing confirmed the lack of a linear association and instead suggested a U-shaped relationship between HbA1c and mortality, with an optimal HbA1c target value of 6.9%. A 1-unit increase in HbA1c with HbA1c less than or equal to 6.9% was predictive of a 55% reduction in all-cause mortality compared to HbA1c levels above 6.9%, which exhibited an elevation in risk. All told, these data suggest that the relationship between HbA1c and all-cause mortality in CVD patients with diabetes is non-linear and U-shaped, and therefore may suggest that individualization of glycemic control may be beneficial for this patient population.

Indexed as

Cardiovascular DiseasesDiabetes ComplicationsGlycated HemoglobinAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedNutrition SurveysRetrospective StudiesUnited StatesYoung AdultGlycated Hemoglobinhemoglobin A1c protein, human

Identifiers

PMID39551840
PMCPMC11570596

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.