Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Department Agrotechnology and Food Sciences, Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands.
PLoS One. 2020 Jun 4;15(6):e0233769. doi: 10.1371/journal.pone.0233769. eCollection 2020.
To investigate the relative contribution of phenotypic and lifestyle factors to HbA1c, independent of fasting plasma glucose (FPG) and 2h post-load glucose (2hPG), in the general population.
The study populations included 2309 participants without known diabetes from the first wave of the Hoorn Study (1989) and 2619 from the second wave (2006). Multivariate linear regression models were used to analyze the relationship between potential determinants and HbA1c in addition to FPG and 2hPG. The multivariate model was derived in the first wave of the Hoorn Study, and replicated in the second wave.
In both cohorts, independent of FPG and 2hPG, higher age, female sex, larger waist circumference, and smoking were associated with a higher HbA1c level. Larger hip circumference, higher BMI, higher alcohol consumption and vitamin C intake were associated with a lower HbA1c level. FPG and 2hPG together explained 41.0% (first wave) and 53.0% (second wave) of the total variance in HbA1c. The combination of phenotypic and lifestyle determinants additionally explained 5.7% (first wave) and 3.9% (second wave).
This study suggests that, independent of glucose, phenotypic and lifestyle factors are associated with HbA1c, but the contribution is relatively small. These findings contribute to a better understanding of the low correlation between glucose levels and HbA1c in the general population.
在一般人群中，研究表型和生活方式因素对糖化血红蛋白（HbA1c）的相对贡献，这些因素独立于空腹血糖（FPG）和餐后 2 小时血糖（2hPG）。
研究人群包括来自霍恩研究第一波（1989 年）的 2309 名无已知糖尿病的参与者和第二波（2006 年）的 2619 名参与者。除 FPG 和 2hPG 外，多变量线性回归模型还用于分析潜在决定因素与 HbA1c 之间的关系。多变量模型在霍恩研究的第一波中得出，并在第二波中得到复制。
在两个队列中，独立于 FPG 和 2hPG，年龄较大、女性、较大的腰围和吸烟与 HbA1c 水平较高相关。较大的臀围、较高的 BMI、较高的酒精摄入量和维生素 C 摄入量与较低的 HbA1c 水平相关。FPG 和 2hPG 共同解释了 HbA1c 总变异的 41.0%（第一波）和 53.0%（第二波）。表型和生活方式决定因素的组合另外解释了 HbA1c 的 5.7%（第一波）和 3.9%（第二波）。
本研究表明，独立于葡萄糖，表型和生活方式因素与 HbA1c 相关，但贡献相对较小。这些发现有助于更好地理解一般人群中血糖水平与 HbA1c 之间的低相关性。
