K-I Kim1, S Kim, K-W Kim, H-C Jang, C-H Kim, H J Chin. 1. Ho Jun Chin, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gumi-ro 166, Bundang-gu, Seongnam-si, Kyeongi-do, 463-707, Republic of Korea, E-mail: mednep@snubh.org, Telephone: 82-31-787-7025, Fax: 82-31-787-4052.
Abstract
OBJECTIVE: To describe the health characteristics of individuals with low HbA1c levels and evaluate the association between HbA1c level and disability or all-cause mortality in non-diabetic older adults. DESIGN: Prospective observational cohort study. SETTING: Seongnam, Gyeongi Province, Korea. PARTICIPANTS: Among the 1,000 community-dwelling Koreans ≥ 65 years of age who were followed for 5 years, 760 non-diabetic individuals were analyzed. MEASUREMENTS: Activities of Daily Living (ADL) and Instrumental ADL (IADL) were evaluated and mortality data were obtained from the National Statistics Office of Korea. RESULTS: The mean age was 76.3 (SD 9.0) years, and 319 subjects (42.0%) were male. Lower level of HbA1c was associated with less frequent hypertension and less frequent use of aspirin or statin, and lower values of body mass index, hematocrit, total iron-binding capacity, albumin, and cholesterol level. The participants were categorized into 3 groups according to their HbA1c (group I, < 5.5%; group II, 5.5~5.9%; and group III, 6.0 ~ 6.4%). Although, there was no significant difference in functional status according to baseline HbA1c level, disability was more frequently observed as the HbA1c level decrease (18.3% in group I, 12.5% in group II, and 5.3% in group III, p=0.029) at the 5-year follow-up evaluation. There were 172 deaths (22.6%) during the follow-up period. There was no significant difference in mortality among the groups, however, group I had a 2.071-fold higher risk for the incident disability or mortality over group III after adjusting age, gender, and possible confounder (95% CI: 1.040 ~ 4.124, p=0.038). CONCLUSIONS: Lower level of HbA1c was associated with an increased risk of disability in non-diabetic older adults.
OBJECTIVE: To describe the health characteristics of individuals with low HbA1c levels and evaluate the association between HbA1c level and disability or all-cause mortality in non-diabetic older adults. DESIGN: Prospective observational cohort study. SETTING: Seongnam, Gyeongi Province, Korea. PARTICIPANTS: Among the 1,000 community-dwelling Koreans ≥ 65 years of age who were followed for 5 years, 760 non-diabetic individuals were analyzed. MEASUREMENTS: Activities of Daily Living (ADL) and Instrumental ADL (IADL) were evaluated and mortality data were obtained from the National Statistics Office of Korea. RESULTS: The mean age was 76.3 (SD 9.0) years, and 319 subjects (42.0%) were male. Lower level of HbA1c was associated with less frequent hypertension and less frequent use of aspirin or statin, and lower values of body mass index, hematocrit, total iron-binding capacity, albumin, and cholesterol level. The participants were categorized into 3 groups according to their HbA1c (group I, < 5.5%; group II, 5.5~5.9%; and group III, 6.0 ~ 6.4%). Although, there was no significant difference in functional status according to baseline HbA1c level, disability was more frequently observed as the HbA1c level decrease (18.3% in group I, 12.5% in group II, and 5.3% in group III, p=0.029) at the 5-year follow-up evaluation. There were 172 deaths (22.6%) during the follow-up period. There was no significant difference in mortality among the groups, however, group I had a 2.071-fold higher risk for the incident disability or mortality over group III after adjusting age, gender, and possible confounder (95% CI: 1.040 ~ 4.124, p=0.038). CONCLUSIONS: Lower level of HbA1c was associated with an increased risk of disability in non-diabetic older adults.
Authors: Elizabeth Selvin; Michael W Steffes; Hong Zhu; Kunihiro Matsushita; Lynne Wagenknecht; James Pankow; Josef Coresh; Frederick L Brancati Journal: N Engl J Med Date: 2010-03-04 Impact factor: 91.245
Authors: C Barrett Bowling; Patricia Sawyer; Ruth C Campbell; Ali Ahmed; Richard M Allman Journal: J Gerontol A Biol Sci Med Sci Date: 2011-03-31 Impact factor: 6.053
Authors: Rita Rastogi Kalyani; Christopher D Saudek; Frederick L Brancati; Elizabeth Selvin Journal: Diabetes Care Date: 2010-02-25 Impact factor: 19.112
Authors: Riitta Leskinen; Tiina Laatikainen; Markku Peltonen; Esko Levälahti; Riitta Antikainen Journal: Age Ageing Date: 2013-05-14 Impact factor: 10.668
Authors: Emanuele Di Angelantonio; Pei Gao; Hassan Khan; Adam S Butterworth; David Wormser; Stephen Kaptoge; Sreenivasa Rao Kondapally Seshasai; Alex Thompson; Nadeem Sarwar; Peter Willeit; Paul M Ridker; Elizabeth L M Barr; Kay-Tee Khaw; Bruce M Psaty; Hermann Brenner; Beverley Balkau; Jacqueline M Dekker; Debbie A Lawlor; Makoto Daimon; Johann Willeit; Inger Njølstad; Aulikki Nissinen; Eric J Brunner; Lewis H Kuller; Jackie F Price; Johan Sundström; Matthew W Knuiman; Edith J M Feskens; W M M Verschuren; Nicholas Wald; Stephan J L Bakker; Peter H Whincup; Ian Ford; Uri Goldbourt; Agustín Gómez-de-la-Cámara; John Gallacher; Leon A Simons; Annika Rosengren; Susan E Sutherland; Cecilia Björkelund; Dan G Blazer; Sylvia Wassertheil-Smoller; Altan Onat; Alejandro Marín Ibañez; Edoardo Casiglia; J Wouter Jukema; Lara M Simpson; Simona Giampaoli; Børge G Nordestgaard; Randi Selmer; Patrik Wennberg; Jussi Kauhanen; Jukka T Salonen; Rachel Dankner; Elizabeth Barrett-Connor; Maryam Kavousi; Vilmundur Gudnason; Denis Evans; Robert B Wallace; Mary Cushman; Ralph B D'Agostino; Jason G Umans; Yutaka Kiyohara; Hidaeki Nakagawa; Shinichi Sato; Richard F Gillum; Aaron R Folsom; Yvonne T van der Schouw; Karel G Moons; Simon J Griffin; Naveed Sattar; Nicholas J Wareham; Elizabeth Selvin; Simon G Thompson; John Danesh Journal: JAMA Date: 2014-03-26 Impact factor: 56.272