Glycated Hemoglobin and All-Cause and Cause-Specific Mortality in Singaporean Chinese Without Diagnosed Diabetes: The Singapore Chinese Health Study

OBJECTIVEGlycated hemoglobin (HbA_1c) is a robust biomarker of the preceding 2 to 3 months average blood glucose level. The aim of this study was to examine the association between HbA_1c and mortality in a cohort of Southeast Asians.RESULTSRelative to participants with an HbA_1c of 5.4–5.6% (36–38 mmol/mol), participants with HbA_1c ≥6.5% (≥48 mmol/mol) had an increased risk of all-cause, cardiovascular, and cancer mortality during an average of 10.1 years of follow-up; HRs (95% CIs) were 1.96 (1.56–2.46), 2.63 (1.77–3.90), and 1.51 (1.04–2.18), respectively. No level of HbA_1c was associated with increased risk of respiratory mortality. Levels <6.5% HbA_1c were not associated with mortality during follow-up. The results did not materially change after excluding observation of first 3 years post–blood draw.CONCLUSIONSHbA_1c levels consistent with undiagnosed type 2 diabetes (≥6.5%) are associated with an increased risk of all-cause and cause-specific mortality in Chinese men and women.