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The relationship between glycated haemoglobin levels and the risk of giant cell arteritis - a case-control study.

ABSTRACT: Objectives:The EULAR core dataset for observational studies in GCA does not include glycated haemoglobin (HbA1c). A multivariable score to stratify the pre-test probability of GCA also does not include HbA1c. There have been contradictory reports about diabetes mellitus being a risk factor for GCA. We report the first study analysing the relationship of pre-diagnosis HbA1c with the risk of GCA. Methods:This was a single-centre retrospective case-control study conducted in Norfolk, UK. All GCA cases were diagnosed with imaging or biopsy. Each case was assigned two age- and sex-matched controls. The primary outcome measure was the glycaemic status (HbA1c categorized into euglycaemia, pre-diabetes or diabetes mellitus) at diagnosis between cases and controls. The HbA1c was compared between two groups using the Mann-Whitney U test. The glycaemic categorization was compared using the ?2 test. Results:One hundred and twelve cases and 224 controls were included. The median (interquartile range) of HbA1c of cases and controls was 40 (37, 43) and 41 (39, 47) mmol/mol (P?

SUBMITTER: Mukhtyar C

PROVIDER: S-EPMC7380559 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The relationship between glycated haemoglobin levels and the risk of giant cell arteritis - a case-control study.

Mukhtyar Chetan C Myers Holly H Jones Colin C Dhatariya Ketan K

Rheumatology advances in practice 20200528 2

<h4>Objectives</h4>The EULAR core dataset for observational studies in GCA does not include glycated haemoglobin (HbA<sub>1c</sub>). A multivariable score to stratify the pre-test probability of GCA also does not include HbA<sub>1c</sub>. There have been contradictory reports about diabetes mellitus being a risk factor for GCA. We report the first study analysing the relationship of pre-diagnosis HbA<sub>1c</sub> with the risk of GCA.<h4>Methods</h4>This was a single-centre retrospective case-co ...[more]

PMID: 32734138

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Project description:BackgroundThe etiology of giant cell arteritis (GCA) and its predictors are incompletely understood. Previous studies have indicated reduced risk of future development of GCA in individuals with obesity and/or diabetes mellitus. There is limited information on blood lipids before the onset of GCA. The objective of the study was to investigate the relation between apolipoprotein levels and future diagnosis of GCA in a nested case-control analysis.MethodsIndividuals who developed GCA after inclusion in a population-based health survey (the Malmö Diet Cancer Study; N = 30,447) were identified by linking the health survey database to the local patient administrative register and the national patient register. A structured review of medical records was performed. Four controls for every validated case, matched for sex, year of birth, and year of screening, were selected from the database. Anthropometric measures, self-reported physical activity, based on a comprehensive, validated questionnaire, and non-fasting blood samples had been obtained at health survey screening. Concentrations of apolipoprotein A-I (ApoA-I) and apolipoprotein B (ApoB) in stored serum were measured using an immunonephelometric assay. Potential predictors of GCA were examined in conditional logistic regression models.ResultsThere were 100 cases with a confirmed clinical diagnosis of GCA (81% female; mean age at diagnosis 73.6 years). The median time from screening to diagnosis was 12 years (range 0.3-19.1). The cases had significantly higher ApoA-I at baseline screening compared to controls (mean 168.7 vs 160.9 mg/dL, odds ratio [OR] 1.57 per standard deviation (SD); 95% confidence interval [CI] 1.18-2.10) (SD 25.5 mg/dL). ApoB levels were similar between cases and controls (mean 109.3 vs 110.4 mg/dL, OR 0.99 per SD; 95% CI 0.74-1.32) (SD 27.1 mg/dL). The ApoB/ApoA1 ratio tended to be lower in cases than in controls, but the difference did not reach significance. The association between ApoA-I and GCA development remained significant in analysis adjusted for body mass index and physical activity (OR 1.48 per SD; 95% CI 1.09-1.99).ConclusionSubsequent development of GCA was associated with significantly higher levels of ApoA-I. These findings suggest that a metabolic profile associated with lower risk of cardiovascular disease may predispose to GCA.

Dataset Information

The relationship between glycated haemoglobin levels and the risk of giant cell arteritis - a case-control study.

Publications

The relationship between glycated haemoglobin levels and the risk of giant cell arteritis - a case-control study.

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