Independent effects of 2hPG, FPG and HbA1c on cardiovascular risk: analysis of a nationally representative sample from China.

Abstract Aims To evaluate the independence of the effect of 2-hour post-load plasma glucose (2hPG), fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) on cardiovascular disease (CVD) after adjusting for each other and non-glycemic factors. Methods We analyzed data from a nationally representative sample of 174,329 Chinese adults from a survey conducted in 2013–2014. The associations of glycemic measures with the risk of CVD were examined and compared by using logistic regression analyses. Results After adjusting for non-glycemic factors, the odds ratio for one standard-deviation increase of 2hPG, FPG and HbA1c was 1.08 (95% confidence interval [CI]: 1.05-1.11), 1.02 (95% CI: 0.99-1.06) and 1.05 (95% CI: 1.02-1.07), respectively. However, the odds ratio for 2hPG (1.10, 95% CI: 1.05-1.16) remained statistically significant after FPG and HbA1c were added to the models, whereas the odds ratios for FPG and HbA1c became statistically insignificant after 2hPG was adjusted for. The results remained consistent across various scenarios. Conclusions 2hPG showed an effect on cardiovascular risk which was independent from FPG and HbA1c, whereas whether the effects of FPG and HbA1c were independent from 2hPG was open to question. This finding calls for more research on how to better use FPG and HbA1c in diagnosing diabetes.