日本社区居民的血红蛋白 A1c 与 10 年信息处理速度。

Hemoglobin A1c and 10-year information processing speed in Japanese community dwellers.

机构信息

Section of NILS-LSA, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu, Aichi, 474-8511, Japan.

Faculty of Health and Medical Sciences, Aichi Shukutoku University, Katahira 2- 9, Nagakute, Aichi, 480-1197, Japan.

出版信息

Environ Health Prev Med. 2019 Apr 23;24(1):24. doi: 10.1186/s12199-019-0778-8.

DOI:10.1186/s12199-019-0778-8

PMID:31014232

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6480813/

Abstract

BACKGROUND

Hyperglycemia is believed to be a risk factor for cognitive decline, but the longitudinal relationship between hyperglycemia and cognitive decline in the Japanese population is unclear. The present study aimed to clarify the association between blood glucose levels and information processing ability in middle-aged and older adults.

METHODS

The subjects were 866 men and 815 women aged 40-79 years not taking medication for diabetes who participated in the first study wave (1997-2000) and then participated at least once in the subsequent six study waves (2000-2012) of the National Institute for Longevity Sciences-Longitudinal Study of Aging, Japan. Hemoglobin A1c (HbA1c) levels were categorized into four groups (< 5.6, 5.6 to < 6.0, 6.0 to < 6.5, ≥ 6.5%), and a mixed-effects model was used to evaluate the effects of the HbA1c level (four groups) on repeated measures of information processing speed. The models also included baseline age, body mass index, ethanol intake, smoking status, educational level, family income, and history of stroke, hypertension, heart disease, and dyslipidemia as covariates.

RESULTS

Mean (standard deviation) HbA1c and follow-up time in participants were 5.2 (0.5) % and 10.0 (3.6) years, respectively. A linear mixed model showed that the main effect of the four HbA1c groups on information processing ability was not significant in either men or women, but the interaction of HbA1c and time with information processing speed in the higher HbA1c level groups (≥ 6.5% group in men, 6.0 to < 6.5% and ≥ 6.5% groups in women) was significant compared to the lower HbA1c level (< 5.6%) group (P < 0.05). When the slope of information processing speed by HbA1c level at baseline was examined, the slope of information processing speed in the higher HbA1c level (≥ 6.5%) group was higher than in the lower HbA1c level (< 5.6%) group, both in men (- 0.31/year) and in women (- 0.30/year), as well as in women with an HbA1c level of 6.0 to < 6.5% (- 0.40/year).

CONCLUSIONS

Higher baseline HbA1c was associated with greater subsequent decline in information processing ability in Japanese community dwellers, even with the pre-clinical HbA1c level (6.0 to < 6.5%) in women. The results suggest that good glycemic control or prevention of hyperglycemia may contribute to maintaining information processing ability.

摘要

背景

高血糖被认为是认知能力下降的一个危险因素，但在日本人群中，高血糖与认知能力下降之间的纵向关系尚不清楚。本研究旨在阐明中年和老年人的血糖水平与信息处理能力之间的关系。

方法

研究对象为 866 名男性和 815 名 40-79 岁未服用糖尿病药物的参与者，他们参加了第一波研究（1997-2000 年），然后至少参加了随后的六波研究（2000-2012 年）日本国立长寿科学研究所的纵向老龄化研究。将血红蛋白 A1c（HbA1c）水平分为四组（<5.6、5.6-<6.0、6.0-<6.5、≥6.5%），并使用混合效应模型评估 HbA1c 水平（四组）对信息处理速度的重复测量的影响。模型还包括基线年龄、体重指数、乙醇摄入量、吸烟状况、教育水平、家庭收入以及中风、高血压、心脏病和血脂异常的病史作为协变量。

结果

参与者的平均（标准差）HbA1c 和随访时间分别为 5.2（0.5）%和 10.0（3.6）年。线性混合模型显示，HbA1c 四组对男性或女性信息处理能力的主要影响不显著，但 HbA1c 与时间与较高 HbA1c 水平组（男性≥6.5%组，女性 6.0-<6.5%和≥6.5%组）信息处理速度之间的相互作用显著高于较低 HbA1c 水平组（<5.6%）（P<0.05）。当根据基线 HbA1c 水平检查信息处理速度的斜率时，较高 HbA1c 水平（≥6.5%）组的信息处理速度斜率高于较低 HbA1c 水平（<5.6%）组，男性（-0.31/年）和女性（-0.30/年），以及女性的 HbA1c 水平为 6.0-<6.5%（-0.40/年）。