Dose-response relationship between genetically proxied average blood glucose levels and incident coronary heart disease in individuals without diabetes mellitus

Diabetologia. 2021 Apr;64(4):845-849. doi: 10.1007/s00125-020-05377-0. Epub 2021 Jan 26.

Abstract

Aims/hypothesis: Our aim was to investigate the relationship between average blood glucose levels and incident CHD in individuals without diabetes mellitus.

Methods: To investigate average blood glucose levels, we studied HbA1c as predicted by 40 variants previously shown to be associated with both type 2 diabetes and HbA1c. Linear and non-linear Mendelian randomisation analyses were performed to investigate associations with incident CHD risk in 324,830 European ancestry individuals from the UK Biobank without diabetes mellitus.

Results: Every one mmol/mol increase in genetically proxied HbA1c was associated with an 11% higher CHD risk (HR 1.11, 95% CI 1.05, 1.18). The dose-response curve increased at all levels of HbA1c, and there was no evidence favouring a non-linear relationship over a linear one.

Conclusions/interpretations: In individuals without diabetes mellitus, lowering average blood glucose levels may reduce CHD risk in a dose-dependent way.

Keywords: Average blood glucose levels; CHD; Mendelian randomisation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Coronary Disease / blood
  • Coronary Disease / diagnosis
  • Coronary Disease / epidemiology
  • Coronary Disease / genetics*
  • Female
  • Genetic Predisposition to Disease
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Incidence
  • Male
  • Mendelian Randomization Analysis
  • Middle Aged
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Time Factors
  • United Kingdom / epidemiology

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human