Association between serum glycated albumin and risk of cardiovascular disease in a Japanese community: The Hisayama Study

Background and aims: We aimed to investigate the association of serum glycated albumin (GA) levels with the risk of cardiovascular disease (CVD) and its subtypes, including coronary heart disease (CHD) and stroke, in a general Japanese population. Methods: A total of 2965 Japanese community-dwellers aged ≥40 years were followed prospectively for a median of 10.2 years (2002–2012). Serum GA was measured by the enzymatic method and divided into quartiles. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of serum GA levels on CVD risk. Results: During the follow-up, 213 subjects developed CVD; 95 had CHD, and 133 had stroke. The cumulative incidence of CVD, CHD, and stroke increased significantly with increasing serum GA levels (all p for trend <0.02). Compared with the lowest serum GA quartile (<13.6%), the multivariable-adjusted HRs (95% CI) of the highest quartile (≥15.7%) were 2.33 (1.46–3.68) for CVD, 2.23 (1.11–4.50) for CHD, and 2.47 (1.38–4.40) for stroke. In addition, a subgroup analysis showed that CVD risk increased significantly with increasing levels of serum GA in both subjects with and without diabetes mellitus. The increasing trend of CVD risk for higher serum GA levels was also observed in subjects with low hemoglobin A_1c levels (hemoglobin A_1c <5.46%). Conclusions: Our findings suggest that higher serum GA levels are significantly associated with the development of CVD and its subtypes, even among subjects without diabetes or those with normal hemoglobin A_1c levels, in a general Japanese population.