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Glycated hemoglobin and associated risk factors in older adults
Raul A Martins1, John G Jones, Sean P Cumming
1Faculty of Sport Sciences and Physical Education, University of Coimbra, Estádio Universitário, Pavilhão 3, 3040-156 Coimbra, Portugal. raulmartins@fcdef.uc.pt
Insights
Higher HbA1c in older women is linked to body weight and obesity metrics, not functional fitness. Population-based obesity criteria are recommended for identifying elevated HbA1c in older adults.
Area of Science:
- Gerontology
- Metabolic Health
- Cardiovascular Risk Factors
Background:
- Aging is associated with increased risk factors for cardiovascular disease, including obesity, dyslipidemia, and inflammation.
- Hemoglobin A1c (HbA1c) is linked to cardiovascular and ischemic heart disease risk, with obesity playing a central role.
- Understanding these relationships in older adults is crucial for targeted health interventions.
Purpose of the Study:
- To investigate the associations between HbA1c and risk factors such as obesity, functional fitness, lipid profile, and inflammatory markers in older adults.
- To explore sex-based differences in these relationships.
Main Methods:
- 118 participants (65-95 years, 72 women, 46 men) underwent anthropometric measurements, functional fitness tests, and blood sampling.
- Analyses included HbA1c, lipid profiles (TG, TC, HDL-C, LDL-C), hs-CRP, and glycaemia.
- Bivariate/partial correlations and factorial ANOVA were used to analyze associations and group differences.
Main Results:
- Older women exhibited higher HbA1c, glycaemia, TC, and BMI compared to men.
- HbA1c positively correlated with glycaemia, HDL-C, TG/HDL-C ratio, body weight (BW), waist circumference (WC), and BMI.
- No significant association was found between HbA1c and functional fitness, inflammatory markers (hs-CRP), or LDL-C.
Conclusions:
- Older women have higher HbA1c than men, independent of BMI.
- HbA1c is associated with body weight, BMI, and WC, and with atherogenic dyslipidemia (TG and TG/HDL-C ratio).
- Population-based obesity criteria are recommended for identifying higher HbA1c levels in older adults; HbA1c is not linked to functional fitness or aerobic endurance.
Background:
The aim of this study is to investigate the relationships between HbA1c and other risk factors like obesity, functional fitness, lipid profile, and inflammatory status in older adults. Epidemiological evidence suggests that HbA1c is associated with cardiovascular and ischemic heart disease risk. Excess of body weight and obesity are considered to play a central role in the development of these conditions. Age is associated with several risk factors as increased body fat and abdominal fat, deterioration of the lipid profile, diabetes, raising in inflammatory activity, or decreased functional fitness.
Methods:
Data were available from 118 participants aged 65-95 years, including 72 women and 46 men. Anthropometric variables were taken, as was functional fitness, blood pressure and heart rate. Blood samples were collected after 12 h fasting, and HbA1c, hs-CRP, TG, TC, HDL-C, LDL-C, and glycaemia were calculated. Bivariate and partial correlations were performed to explore associations amongst the variables of interest. Differences between groups were explored by performing factorial analysis of variance.
Results:
HbA1c levels ranged from 4.6%-9.4% with 93% of the cases below 6.5%. Women had higher HbA1c, glycaemia, TC, BMI, and lower and upper flexibility than men. Men had higher BW, WC, 6-min walking distance, and VO2peak than women. Age, SBP, DBP, HRrest, HRpeak, HDL-C, LDL-C, TG, TG/HDL-C ratio, Log10 hs-CRP, upper and lower strength, and agility and dynamic balance were similar in men and women. HbA1c had positive associations with glycaemia, HDL-C, TG/HDL-C, BW, WC, BMI, but not with functional fitness, TC, LDL-C, Log10 hs-CRP, PAD, or PAS. Obese participants had higher HbA1c than non-obese only when IDF and not USDHHS criteria were applied.
Conclusions:
Older women had higher HbA1c than men, even after controlling for BMI. HbA1c associates equally with BW, BMI or WC. Population-based criteria are recommended to classify obesity and to identify higher levels of HbA1c in obese older adults. HbA1c associates with atherogenic dyslipidemia particularly with TG and TG/HDL-C ratio, but not with TC, HDL-C, or LDL-C. HbA1c is not associated with hs-CRP, and with functional fitness and aerobic endurance.
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