Alternative measures of hyperglycemia and risk of Alzheimer's disease in the community: the Hisayama Study.

Alternative measures of hyperglycemia and risk of Alzheimer's disease in the community: the Hisayama Study.

J Clin Endocrinol Metab. 2017 Jun 09;:

Authors: Mukai N, Ohara T, Hata J, Hirakawa Y, Yoshida D, Kishimoto H, Koga M, Nakamura U, Kitazono T, Kiyohara Y, Ninomiya T

Abstract
Context and Objective: We investigated the associations of hemoglobin A1c (HbA1c), glycated albumin (GA), the GA/HbA1c ratio, and 1,5-anhydroglucitol (1,5-AG) with the development of Alzheimer's disease (AD) in community-dwelling Japanese subjects.
Design and Participants: A total of 1,187 subjects aged ≥65 years without dementia were followed up for an average of 4.8 years.
Results: During the follow-up, 116 subjects experienced AD. The age- and sex-adjusted incidence of AD increased significantly with higher quartiles of the GA/HbA1c ratio, and a similar tendency was seen for GA, while no such association was observed for HbA1c and 1,5-AG. After adjusting for potential confounding factors, positive association of the GA/HbA1c ratio with the risk of AD remained significant (p for trend=0.01): the multivariable-adjusted hazard ratio (HR) was significantly higher in the third (HR=2.11, 95% confidence interval [CI]=1.16-3.82, p=0.01) and fourth (HR=2.01, 95% CI=1.09-3.68, p=0.02) quartile than in the first quartile. Among subjects with normal glucose tolerance, those with high GA/HbA1c ratio (≥2.83) had a higher risk of AD than those with low GA/HbA1c ratio (<2.83) (HR=1.82, 95% CI=1.05-3.16, p=0.03), and a similar tendency was found in those with glucose intolerance (HR=1.73, 95% CI=0.96-3.13, p=0.07). No such associations were observed for HbA1c, GA, and 1,5-AG, regardless of glucose tolerance status.
Conclusions: Our findings suggest that the elevated GA/HbA1c ratio-but not the HbA1c, GA, or 1,5-AG level-is significantly associated with the risk of AD both in subjects with and without glucose intolerance. The GA/HbA1c ratio may be a useful biomarker for predicting incident AD.

PMID: 28605542 [PubMed - as supplied by publisher]

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