This association between elevated HbA1c and early atherosclerosis progression supports the hypothesis that HbA1c may be causally related to CHD even at low levels.33 Hyperglycemia, in addition to diabetes, can lead to the formation of advanced glycosylated end products, which have been shown to induce production and secretion of inflammatory cytokines.34 Indeed, HbA1c has been reported to predict CRP in established diabetes.35 In addition, nitric oxide bioavailability, a marker of intimal reactivity, has been shown to be reduced by both CRP36 and HbA1c. Here, CRP is linked to coronary artery disorder.