Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study

Background. Diabetes mellitus (DM) and dyslipidemia are the main risk factors for atherosclerosis. Elevated glycosylated hemoglobin A1c (HbA1c) and reduced high-density lipoprotein cholesterol (HDL-C) are associated with the progression of atherosclerosis. The aim of this study is at exploring the r...

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Main Authors: Xiangming Hu, Wei Li, Chenyang Wang, Haotian Zhang, Haoyu Lu, Guang Li, Yingling Zhou, Haojian Dong
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2021/9238566
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author Xiangming Hu
Wei Li
Chenyang Wang
Haotian Zhang
Haoyu Lu
Guang Li
Yingling Zhou
Haojian Dong
author_facet Xiangming Hu
Wei Li
Chenyang Wang
Haotian Zhang
Haoyu Lu
Guang Li
Yingling Zhou
Haojian Dong
author_sort Xiangming Hu
collection DOAJ
description Background. Diabetes mellitus (DM) and dyslipidemia are the main risk factors for atherosclerosis. Elevated glycosylated hemoglobin A1c (HbA1c) and reduced high-density lipoprotein cholesterol (HDL-C) are associated with the progression of atherosclerosis. The aim of this study is at exploring the relationship between the HbA1c/HDL-C ratio and atherosclerosis evaluated using carotid artery intima-media thickness (cIMT) and carotid artery plaque. Methods. In this retrospective study, we enrolled 1304 patients who had multiple cardiovascular risk factors or symptoms of suspected coronary artery disease. cIMT and carotid artery plaque were measured using ultrasonography. Logistic regression was used to explore the correlation between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. We used restricted cubic spline curves to assess nonlinear relationships between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. Results. With increased quartiles of HbA1c/HDL-C, patients had higher cIMT and a greater carotid plaque burden. After adjusting for other relevant clinical covariates, patients with the highest HbA1c/HDL-C ratio (quartile 4 (Q4)) had a 2.88 times (95% confidence interval (CI): 2.02–4.10, P<0.001) more abnormal mean cIMT, 3.72 times (95% CI: 2.55–5.44, P<0.001) more abnormal maximum cIMT, and 2.58 times (95% CI: 1.70–3.91, P<0.001) greater carotid artery plaque burden compared with patients who had the lowest HbA1c/HDL-C ratio (Q1). Moreover, the association of HbA1c/HDL-C with atherosclerosis remained significant in a subsample of patients with and without DM. Conclusion. As a novel compound indicator for evaluating blood glucose homeostasis and dyslipidemia, the HbA1c/HDL-C ratio was positively correlated with carotid atherosclerosis evaluated using the mean and maximum cIMT as well as the carotid artery plaque burden.
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spelling doaj-art-d6b957ffc6624cde8846bdd731f5df7c2025-02-03T05:57:20ZengWileyJournal of Diabetes Research2314-67532021-01-01202110.1155/2021/9238566Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective StudyXiangming Hu0Wei Li1Chenyang Wang2Haotian Zhang3Haoyu Lu4Guang Li5Yingling Zhou6Haojian Dong7The Second School of Clinical MedicineDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyDepartment of CardiologyBackground. Diabetes mellitus (DM) and dyslipidemia are the main risk factors for atherosclerosis. Elevated glycosylated hemoglobin A1c (HbA1c) and reduced high-density lipoprotein cholesterol (HDL-C) are associated with the progression of atherosclerosis. The aim of this study is at exploring the relationship between the HbA1c/HDL-C ratio and atherosclerosis evaluated using carotid artery intima-media thickness (cIMT) and carotid artery plaque. Methods. In this retrospective study, we enrolled 1304 patients who had multiple cardiovascular risk factors or symptoms of suspected coronary artery disease. cIMT and carotid artery plaque were measured using ultrasonography. Logistic regression was used to explore the correlation between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. We used restricted cubic spline curves to assess nonlinear relationships between the HbA1c/HDL-C ratio and cIMT or carotid artery plaque. Results. With increased quartiles of HbA1c/HDL-C, patients had higher cIMT and a greater carotid plaque burden. After adjusting for other relevant clinical covariates, patients with the highest HbA1c/HDL-C ratio (quartile 4 (Q4)) had a 2.88 times (95% confidence interval (CI): 2.02–4.10, P<0.001) more abnormal mean cIMT, 3.72 times (95% CI: 2.55–5.44, P<0.001) more abnormal maximum cIMT, and 2.58 times (95% CI: 1.70–3.91, P<0.001) greater carotid artery plaque burden compared with patients who had the lowest HbA1c/HDL-C ratio (Q1). Moreover, the association of HbA1c/HDL-C with atherosclerosis remained significant in a subsample of patients with and without DM. Conclusion. As a novel compound indicator for evaluating blood glucose homeostasis and dyslipidemia, the HbA1c/HDL-C ratio was positively correlated with carotid atherosclerosis evaluated using the mean and maximum cIMT as well as the carotid artery plaque burden.http://dx.doi.org/10.1155/2021/9238566
spellingShingle Xiangming Hu
Wei Li
Chenyang Wang
Haotian Zhang
Haoyu Lu
Guang Li
Yingling Zhou
Haojian Dong
Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study
Journal of Diabetes Research
title Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study
title_full Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study
title_fullStr Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study
title_full_unstemmed Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study
title_short Association between the Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio and Carotid Atherosclerosis: A Retrospective Study
title_sort association between the plasma glycosylated hemoglobin a1c high density lipoprotein cholesterol ratio and carotid atherosclerosis a retrospective study
url http://dx.doi.org/10.1155/2021/9238566
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