Naoko Mukai1,2,3, Tomoyuki Ohara2,4, Jun Hata1,2,3, Yoichiro Hirakawa1,2,3, Daigo Yoshida1,2, Hiro Kishimoto1,2, Masafumi Koga5, Udai Nakamura3, Takanari Kitazono1,3, Yutaka Kiyohara6, Toshiharu Ninomiya1,2. 1. Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. 2. Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. 3. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. 4. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. 5. Department of Internal Medicine, Hakuhokai Central Hospital, Hyogo 661-0953, Japan. 6. Hisayama Research Institute for Lifestyle Diseases, Fukuoka 812-8582, Japan.
Abstract
Context and Objective: We investigated the associations of hemoglobin A1c (HbA1c), glycated albumin (GA), GA/HbA1c ratio, and 1,5-anhydroglucitol (1,5-AG) with the development of Alzheimer's disease (AD). Design and Participants: A total of 1187 community-dwelling Japanese subjects aged ≥65 years without dementia were followed up for an average of 4.8 years. Results: The age- and sex-adjusted incidence of AD increased significantly with higher quartiles of GA/HbA1c ratio, and a similar tendency was seen for GA, whereas no such association was observed for HbA1c and 1,5-AG. After adjusting for potential confounding factors, positive association of GA/HbA1c ratio with the risk of AD remained significant: the multivariable-adjusted hazard ratio (HR) was significantly higher in the third [HR = 2.11, 95% confidence interval (CI) = 1.16 to 3.82] and fourth (HR = 2.01, 95% CI = 1.09 to 3.68) quartile than in the first quartile. Among subjects with normal glucose tolerance, those with high GA/HbA1c ratio had a higher risk of AD than those with low GA/HbA1c ratio (HR = 1.82, 95% CI = 1.05 to 3.16), and a similar tendency was found in those with glucose intolerance (HR = 1.73, 95% CI = 0.96 to 3.13). No such associations were observed for HbA1c, GA, and 1,5-AG, regardless of glucose tolerance status. Conclusions: Our findings suggest that elevated GA/HbA1c ratio-but not HbA1c, GA, or 1,5-AG level-is significantly associated with the risk of AD in subjects both with and without glucose intolerance. GA/HbA1c ratio may be a useful biomarker for predicting incident AD.
Context and Objective: We investigated the associations of hemoglobin A1c (HbA1c), glycated albumin (GA), GA/HbA1c ratio, and 1,5-anhydroglucitol (1,5-AG) with the development of Alzheimer's disease (AD). Design and Participants: A total of 1187 community-dwelling Japanese subjects aged ≥65 years without dementia were followed up for an average of 4.8 years. Results: The age- and sex-adjusted incidence of AD increased significantly with higher quartiles of GA/HbA1c ratio, and a similar tendency was seen for GA, whereas no such association was observed for HbA1c and 1,5-AG. After adjusting for potential confounding factors, positive association of GA/HbA1c ratio with the risk of AD remained significant: the multivariable-adjusted hazard ratio (HR) was significantly higher in the third [HR = 2.11, 95% confidence interval (CI) = 1.16 to 3.82] and fourth (HR = 2.01, 95% CI = 1.09 to 3.68) quartile than in the first quartile. Among subjects with normal glucose tolerance, those with high GA/HbA1c ratio had a higher risk of AD than those with low GA/HbA1c ratio (HR = 1.82, 95% CI = 1.05 to 3.16), and a similar tendency was found in those with glucose intolerance (HR = 1.73, 95% CI = 0.96 to 3.13). No such associations were observed for HbA1c, GA, and 1,5-AG, regardless of glucose tolerance status. Conclusions: Our findings suggest that elevated GA/HbA1c ratio-but not HbA1c, GA, or 1,5-AG level-is significantly associated with the risk of AD in subjects both with and without glucose intolerance. GA/HbA1c ratio may be a useful biomarker for predicting incident AD.
Authors: Andreea M Rawlings; A Richey Sharrett; Marilyn S Albert; Josef Coresh; B Gwen Windham; Melinda C Power; David S Knopman; Keenan Walker; Sheila Burgard; Thomas H Mosley; Rebecca F Gottesman; Elizabeth Selvin Journal: Diabetes Care Date: 2019-05-21 Impact factor: 19.112
Authors: Michael Bergman; Muhammad Abdul-Ghani; Ralph A DeFronzo; Melania Manco; Giorgio Sesti; Teresa Vanessa Fiorentino; Antonio Ceriello; Mary Rhee; Lawrence S Phillips; Stephanie Chung; Celeste Cravalho; Ram Jagannathan; Louis Monnier; Claude Colette; David Owens; Cristina Bianchi; Stefano Del Prato; Mariana P Monteiro; João Sérgio Neves; Jose Luiz Medina; Maria Paula Macedo; Rogério Tavares Ribeiro; João Filipe Raposo; Brenda Dorcely; Nouran Ibrahim; Martin Buysschaert Journal: Diabetes Res Clin Pract Date: 2020-06-01 Impact factor: 5.602