Chng Abigail C C, Tan Hong Chang, Teo Louis L Y, Tan Ru-San, Ewe See Hooi, Leng Shuang, Zhao Xiao-Dan, Zhong Liang, Koh Woon-Puay, Kovalik Jean-Paul, Gao Fei, Koh Angela S
National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
Duke-NUS Medical School, Singapore, Singapore.
Geroscience. 2025 Apr;47(2):1911-1921. doi: 10.1007/s11357-024-01387-7. Epub 2024 Oct 14.
Glycated haemoglobin (HbA1c) is a well-established biomarker for diabetes diagnosis and management and is linked to risk of cardiovascular death. However, among adults without cardiovascular disease (CVD) and diabetes, the value of HbA1c in predicting distinct signatures of myocardial ageing has not been explored.
Subjects, from among older adults without CVD, underwent comprehensive cardiovascular and metabolic assessment. Transthoracic echocardiography measured left ventricular structure and function. Longitudinal left atrial (LA) strain comprising reservoir strain (Ɛs), conduit strain (Ɛe) and booster strain (Ɛa) and their corresponding peak strain rates (SRs, SRe, SRa) were measured using cardiac magnetic resonance (CMR). Blood sampling for biomarkers and cardiovascular examinations were performed.
247 subjects (mean age 71 years, 44.1% female, mean HbA1c 6.0%) were included. HbA1c was significantly associated with E/A ratio (p < 0.0001), conduit strain (Ɛe) (p < 0.0001), conduit strain rate SRe (p < 0.0001), and conduit strain rate to booster strain rate SRe:SRa ratio (p < 0.0001). Multivariate models adjusting for clinical variables such as body mass index, blood pressure, heart rate, diabetes mellitus, smoking, and associated cardiac parameters, demonstrated a persistent independent association. Each unit increase in HbA1c was associated with lower E/A ratio, lower Ɛe, higher SRe and lower SRe:SRa ratio. These associations remained significant after diabetic subjects were excluded.
Distinct associations were found between HbA1c and myocardial functions of interest in the ageing heart. HbA1c may be useful biomarker for stratifying risks associated with myocardial ageing, independent of diabetes status.
ClinicalTrials.gov Identifier: NCT02791139.
糖化血红蛋白（HbA1c）是用于糖尿病诊断和管理的成熟生物标志物，且与心血管死亡风险相关。然而，在无心血管疾病（CVD）和糖尿病的成年人中，尚未探究HbA1c在预测心肌衰老不同特征方面的价值。
选取无CVD的老年人作为研究对象，进行全面的心血管和代谢评估。经胸超声心动图测量左心室结构和功能。采用心脏磁共振成像（CMR）测量纵向左心房（LA）应变，包括储存应变（Ɛs）、管道应变（Ɛe）和增强应变（Ɛa）及其相应的峰值应变率（SRs、SRe、SRa）。采集血样检测生物标志物并进行心血管检查。
纳入247名受试者（平均年龄71岁，44.1%为女性，平均HbA1c为6.0%）。HbA1c与E/A比值（p < 0.0001）、管道应变（Ɛe）（p < 0.0001）、管道应变率SRe（p < 0.0001）以及管道应变率与增强应变率的比值SRe:SRa（p < 0.0001）显著相关。在对体重指数、血压、心率、糖尿病、吸烟及相关心脏参数等临床变量进行校正的多变量模型中，这种关联持续存在且具有独立性。HbA1c每升高一个单位，E/A比值降低、Ɛe降低、SRe升高且SRe:SRa比值降低。排除糖尿病受试者后，这些关联依然显著。
发现HbA1c与老年心脏感兴趣的心肌功能之间存在独特关联。HbA1c可能是用于对与心肌衰老相关风险进行分层的有用生物标志物，与糖尿病状态无关。
ClinicalTrials.gov标识符：NCT02791139。
