Aim : To study relationship between hemoglobin A1c level and cardiometabolic risk factors.
Methods : A cross sectional study in Sohag Governorate and involved 200 patients who were already diagnosed or newly diagnosed to be diabetic. Patients subdivided into 3 groups according to HbA1c level as following: Group 1: HbA1c below 7,Group 2: HbA1c 7 to less than 9, Group 3: HbA1c more than 9 . Detailed history was taken including: Age, Sex, Residence, Education, Smoking, duration of diabetes and type of treatment used, HTN or other current illness. Thorough clinical examination (general, chest, cardiac, and abdominal) was done. Laboratory investigation including Hemoglobin A1c and lipid profile were also done.
Results : we found a strong relation between HBA1c level and (BMI) as the higher BMI is associated with higher levels of HBA1c, as our study included 99 patient with HBA1c more than 9 (49.5 %), this group with mean value of BMI = 29.26. Regarding hypertension 111 patients were hypertensive and 89 patients were non-hypertensive, also 14.5% of studied people had history of Ischemic heart diseases, 85.5% with no history of this problem, 42.5% were smokers and 57.5% were non-smokers. We found significant increase of HBA1c level in hypertensive patients as they were with mean value of HB A1c >10. Also, smoking and history of IHD were associated with higher levels of HBA1c. After multivariate analysis of our data we found overweight and obesity (BMI>25) and hypertension are independent risk factors that are associated with higher levels of HbA1c with the same strength, while smoking is a dependent risk factor that affects HbA1c in presence of other risk factors only. There is no significant relation between dyslipidemia and HbA1c level. Regression analysis of our data and after we divided the patients into 4 groups according to number of risk factors in the same patient we found that increase in number of present risk factors is associated with higher levels of HbA1c.
Conclusion: Target levels of HBA1c will only be obtained if other concomitant cardiometabolic risk factors are strictly controlled, this finding calls for consideration of cardiovascular risk factor clustering in deciding medical therapies to optimize glycemic control in individuals with diabetes. Interventions designed to achieve glycemic control coupled with modification of cardiometabolic risk factors may be crucial in alleviating sequelae resulting from diabetes.