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Glycated albumin to HbA1c ratio may predict incident Alzheimer’s disease
In older Japanese adults with and without normal glucose tolerance, the glycated albumin to HbA1c ratio may serve as a useful biomarker for predicting incident Alzheimer’s disease, according to findings from a prospective, longitudinal study.
“Intriguingly, high [glycated albumin]/HbA1c ratio levels increased the risk of [Alzheimer’s disease] both in subjects with and without glucose intolerance,” Naoko Mukai, MD, PhD, of the Center for Cohort Studies at the Graduate School of Sciences, Kyushu University, Fukuoka, Japan, and colleagues wrote. “The [glycated albumin]/HbA1c ratio can be measured easily in a single blood test without fasting or glucose-load, and thus the [glycated albumin]/HbA1c ratio would be a useful and practical tool to identify individuals at increased risk for [Alzheimer’s disease].”
Mukai and colleagues analyzed data from 1,187 older adults without dementia at baseline who completed surveys every 6 or 7 years on cognitive impairment as part of a population-based, prospective study of cerebro-cardiovascular diseases and their risk factors, underway since 1961 (mean age, 73 years; 54.9% women). Researchers assessed measurements of HbA1c, glycated albumin and 1,5-anhydroglucitol (1,5-AG) in screenings for the present study conducted in 2007 and 2008; the cohort was followed through November 2012 (mean follow-up time, 4.8 years). Researchers assessed age- and sex-adjusted incidence of Alzheimer’s disease according to quartiles of each glycemic measure.
During follow-up, 116 adults developed Alzheimer’s disease.
Researchers observed an increased incidence of Alzheimer’s disease with higher glycated albumin to HbA1c ratio (P for trend < .01) and “appreciably, but not significantly” increased incidence with elevated glycated albumin levels (P for trend = .06); however, there were no associations observed between Alzheimer’s disease incidence and measures of HbA1c and 1,5-AG.
After adjustment for multiple, additional factors, including comorbidities, BMI, physical activity, smoking status, alcohol intake and education level, participants in the highest quartile of glycated albumin to HbA1c ratio ( 3.04) were twice as likely to develop Alzheimer’s disease compared with participants in the lowest quartile of glycated albumin to HbA1c ratio (OR = 2.01; 95% CI, 1.17-3.81). Results persisted after additional adjustment for diabetes medications and duration of diabetes (HR = 1.93; 95% CI, 1.03-3.59).
In sensitivity analyses excluding participants with anemia, renal failure or underweight, additional adjustment for serum alanine aminotransferase did not change the findings, according to the researchers.
“The use of [glycated albumin]/HbA1c ratio in clinical practice may help to extract individuals at high risk for [Alzheimer’s disease], which is increasingly recognized as a global health priority,” the researchers wrote. “Further epidemiological and basic studies are needed to verify these findings and underlying mechanisms.” – by Regina Schaffer
Disclosures : The researchers report no relevant financial disclosures.