Dataset Information

Elevated serum glycated albumin and glycated albumin : hemoglobin A_1c ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.

ABSTRACT:

Aims/introduction

To investigate the association of alternative glycemic measures - namely, serum glycated albumin (GA), hemoglobin A_1c (HbA_1c ) and the GA : HbA_1c ratio - with global brain and hippocampal atrophy in a general elderly Japanese population.

Materials and methods

A total of 1,278 Japanese individuals aged ≥65 years in a community participated in brain magnetic resonance imaging scanning and screening examination of health status in 2012. We measured total brain volume (TBV), hippocampal volume (HV) and intracranial volume (ICV) using the data from the magnetic resonance imaging examination. The association of each glycemic measure with the ratios of TBV : ICV (an indicator of global brain atrophy) and HV : ICV (an indicator of hippocampal atrophy) was examined by analysis of covariance.

Results

The mean values of the TBV : ICV and HV : ICV ratios decreased significantly with elevating serum GA levels and GA : HbA_1c ratio levels (all P for trend < 0.05), but not with higher HbA_1c levels, after adjusting for age, sex, low education, systolic blood pressure, antihypertensive medication, diabetes mellitus, serum total cholesterol, electrocardiogram abnormalities, body mass index, smoking habits, alcohol drinking habits and regular exercise. These significant associations were still observed in the sensitivity analysis after excluding individuals with mild cognitive impairment and dementia. In addition, increased serum GA levels and the GA : HbA_1c ratio levels, but not HbA_1c , were closely associated with lower mean values of the TBV : ICV and HV : ICV ratios, irrespective of the presence or absence of diabetes mellitus.

Conclusions

The present study suggests that higher serum GA and higher GA : HbA_1c ratio are significantly associated with global brain and hippocampal atrophy.

SUBMITTER: Ohara T

PROVIDER: S-EPMC7378434 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Elevated serum glycated albumin and glycated albumin : hemoglobin A<sub>1c</sub> ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.

Ohara Tomoyuki T Furuta Yoshihiko Y Hirabayashi Naoki N Hata Jun J Hirakawa Yoichiro Y Honda Takanori T Yoshida Daigo D Shibata Mao M Kitazono Takanari T Ninomiya Toshiharu T

Journal of diabetes investigation 20200301 4

<h4>Aims/introduction</h4>To investigate the association of alternative glycemic measures - namely, serum glycated albumin (GA), hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub> ) and the GA : HbA<sub>1c</sub> ratio - with global brain and hippocampal atrophy in a general elderly Japanese population.<h4>Materials and methods</h4>A total of 1,278 Japanese individuals aged ≥65 years in a community participated in brain magnetic resonance imaging scanning and screening examination of health status in 20 ...[more]

PMID: 31999889

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Project description:IntroductionObesity is associated with compromised glucose metabolism. Hence, it is of interest to investigate if the lifestyle interventions used in the LIBRA-cohort, which aimed at not only weight loss, but also patient well-being, could also help obese patients improve glucose metabolism by evidence of reduced HbA1c. The aim of the study was to retrospectively investigate if patients who were referred to a lifestyle intervention for obesity, were able to alter HbA1c.Research design and methodsPatients with a BMI≥30 undergoing a 6-month lifestyle intervention, who also completed physical and mental health surveys and whose baseline and 6-month blood samples were available, were included in the analysis. For changes in HbA1c and body weight a clinically relevant change of 5≥mmom/mol and 5%≥, respectively, was chosen. Participants were divided into groups according to their baseline HbA1c level: "Diabetes": HbA1c of ≥6.5% (≥48 mmol/mol), "Prediabetes": HbA1c of 5.7% to 6.4% (39-47.99 mmol/mol) or "Normal" HbA1c <5.7% (<39 mmol/mol).Results180 patients met the stated inclusion criteria and these patients were divided into groups (median age (25th;75th quartile): Diabetes: n=47, age 54 (43;60), 51% women, Prediabetes: n=68, age 60 (50;66), 71% women and Normal: n=65, median age 61 (50;66), 85% women. Significant reductions were found in all three groups and specifically in the diabetes group HbA1c was reduced (mean [95%CI]) -5[-8;-2] mmol/mol from baseline to the end of the intervention. Furthermore, 35% of patients with prediabetes normalized their HbA1c (<39) and 30% patients with diabetes reduced their HbA1c <48. All groups had clinically relevant (≥5%) reductions in body weight (p<0.01). There was an association between body weight reduction and HbA1c reduction in the diabetes group (p<0.01). All groups reported improvements in physical health (p<0.01).ConclusionIn this retrospective cohort study, all patients achieved clinically relevant weight loss after participation in the lifestyle intervention and obese patients with diabetes achieved clinically relevant reductions in HbA1c after 6-months. More than 1/3 of patients with prediabetes normalized their HbA1c.

Project description:BackgroundCombining HbA1c with glycated albumin (GA) may improve detection of dysglycaemia. As BMI correlates positively with HbA1c and negatively with GA, HbA1c may be more effective in obese and GA in nonobese individuals.MethodsTo relate these findings to Africans, we assessed in 1274 South Africans living in CapeTown (male 26%; age 48±16y; BMI 28.7 kg/m2 (range 15.6-73.8); obesity 39.9% and no prior diabetes history) the: (1) correlation of BMI with HbA1c and GA, (2) ability of HbA1c and GA separately and jointly, to detect OGTT-diagnosed dysglycaemia (diabetes plus prediabetes). Data collection took place between 2014 and 2016 in the City of Cape Town. Dysglycaemia was diagnosed by glucose criteria for the OGTT. Youden index was used to optimize diagnostic thresholds for HbA1c and GA.FindingsNormal glucose tolerance, prediabetes and diabetes occurred in 76%, 17% and 7%, respectively. BMI positively correlated with HbA1c [r = 0·34 [95%CI: 0·29,0·39)] and negatively with GA [-0·08 (0·13,0·03)]. For HbA1c the optimal threshold by Youden-index for dysglycaemia diagnosis was: 6·0% (95%CI: 5·8,6·2) and for GA: 13·44% (12·72,14·71). In the nonobese, obese and total cohort, HbA1c-alone detected: 51% (42-60), 72% (65,78), 63% (57,68), respectively; GA-alone detected 55% (52% (46,63), 52% (44, 59) and 53% (47,53), respectively; whereas: HbA1c+GA detected: 69% (60,76), 82% (75,87) and 76% (71, 81). Therefore, for the total cohort detection of dysglycaemia HbA1c-alone vs HbA1c+GA detected 63% (57,68) vs 76% (71,81).InterpretationThe opposite correlations of HbA1c and GA with BMI have now been demonstrated in an African-based population. Improving detection of dysglycaemia by combining HbA1c and GA has important implications for diabetes risk screening.FundingAES is supported by the intramural programs of the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Minority Health and Health Disparities of the National Institutes of Health (NIH, Bethesda, Maryland, USA). DBS is supported by the intramural program of the Clinical Center of NIH. The South African Medical Research Council (SAMRC) funded the VMH study with funds from the National Treasury under its Economic Competitiveness and Support Package (MRC-RFA-UFSP-01-2013/VMH Study).

Dataset Information

Elevated serum glycated albumin and glycated albumin : hemoglobin A_1c ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.

Aims/introduction

Materials and methods

Results

Conclusions

Publications

Elevated serum glycated albumin and glycated albumin : hemoglobin A<sub>1c</sub> ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

Elevated serum glycated albumin and glycated albumin : hemoglobin A1c ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.

Aims/introduction

Materials and methods

Results

Conclusions

Publications

Elevated serum glycated albumin and glycated albumin : hemoglobin A<sub>1c</sub> ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Elevated serum glycated albumin and glycated albumin : hemoglobin A_1c ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study.