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The nonlinear association between HbA1c and cognitive impairment in patients with alcohol use disorder

Mengling Deng1,2, Guomin Wang2, Xiaofeng Gao2

  • 1Graduate School, Zhejiang Chinese Medical University, Hangzhou, China.

Journal of Addictive Diseases
|September 12, 2022
PubMed

Insights

Higher glycated hemoglobin (HbA1c) levels are linked to cognitive impairment in individuals with alcohol use disorder. This association suggests potential impacts of glucose control on brain function in this population.

Area of Science:

  • Neuroscience
  • Endocrinology
  • Psychiatry

Background:

  • Elevated glycated hemoglobin (HbA1c) is linked to cognitive deficits, even without diabetes.
  • The relationship between HbA1c and cognitive decline in alcohol use disorder (AUD) remains unclear.
  • This study addresses the gap in understanding HbA1c's role in cognitive impairment within AUD patients.

Purpose of the Study:

  • To investigate the association between HbA1c levels and cognitive impairment in patients diagnosed with alcohol use disorder.
  • To determine if HbA1c is a significant factor in cognitive function decline among individuals with AUD.

Main Methods:

  • Recruited 227 patients with alcohol-related cognitive impairment from January 2019 to February 2022.
  • Measured HbA1c levels and administered the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) after monitored abstinence.
  • Employed univariate, multivariate linear regression, and generalized additive models (GAMs) to analyze HbA1c's association with cognitive scores.

Main Results:

  • Both univariate and multivariate analyses revealed a significant negative association between HbA1c levels and MMSE/MoCA scores, even after adjusting for confounders (P < 0.05).
  • GAM analysis indicated a bell-shaped relationship between HbA1c and cognitive scores (MMSE and MoCA).
  • Identified inflection points for the bell-shaped relationship at 5.3% for MMSE and 5.2% for MoCA.

Conclusions:

  • HbA1c levels are significantly associated with cognitive impairment in patients with alcohol use disorder.
  • The findings suggest a complex, potentially non-linear relationship between glucose control and cognitive function in AUD.
  • Further research is warranted to explore the impact of optimizing glucose control on cognitive outcomes in individuals with AUD.

Keywords:
Alcohol use disordercognitive impairmentgeneralized additive modelglycated hemoglobin

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