Byambasukh Oyuntugs, Nordog Munkhuchral, Suya Bao, Galsanjigmed Narkhajid, Dashnyam Altangadas, Khasag Altaisaikhan, Tsogbadrakh Odgerel, Altangerel Otgonbat
Department of Endocrinology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
Department of Internal Medicine, Mongolia-Japan Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
J Clin Med. 2024 Dec 9;13(23):7487. doi: 10.3390/jcm13237487.
: While a positive correlation between age and HbA1c has been suggested in non-diabetic individuals, warranting higher HbA1c reference ranges for older adults, evidence among individuals with diabetes is less clear and may reveal an inverse trend. This study aimed to examine the relationship between age and HbA1c in a diabetic population, considering red cell parameters and other confounding factors; : This cross-sectional study included 268 diabetic participants from Mongolia-Japan University Hospital (mean age 57.0 ± 9.9 years, 38.8% male, median diabetes duration 8.0 years, mean HbA1c 9.2 ± 3.3%). We analyzed the association between age and HbA1c using linear regression models, adjusting for diabetic characteristics, chronic complications, inflammation markers, and red cell indices. Subgroup analyses were conducted based on red cell distribution width (RDW) median splits; : A significant negative association between age and HbA1c was observed, with an unstandardized B coefficient (95% CI) of -0.112 (-0.166; -0.058, < 0.001). This association persisted after adjustment for diabetic characteristics, complications, inflammation markers, and red cell indices (-0.115, -0.179; -0.051, = 0.001). Subgroup analyses indicated a stronger negative association in participants with lower RDW levels (-0.174, -0.269; -0.079, < 0.001) compared to those with higher RDW (-0.080, -0.147; -0.014, = 0.019), suggesting that red cell characteristics may modify this relationship. No significant interactions were identified except for RDW; : Our findings reveal a distinct negative association between age and HbA1c in diabetic individuals, independent of diabetic characteristics, complications, and inflammation markers. This association is particularly pronounced in individuals with lower RDW levels, highlighting the potential role of red cell morphology in influencing HbA1c levels with aging in diabetes.
虽然在非糖尿病个体中年龄与糖化血红蛋白（HbA1c）之间存在正相关，这使得老年人的HbA1c参考范围更高，但糖尿病患者中的证据尚不明确，可能呈现相反的趋势。本研究旨在探讨糖尿病患者人群中年龄与HbA1c之间的关系，同时考虑红细胞参数和其他混杂因素。这项横断面研究纳入了蒙古-日本大学医院的268名糖尿病参与者（平均年龄57.0±9.9岁，男性占38.8%，糖尿病病程中位数为8.0年，平均HbA1c为9.2±3.3%）。我们使用线性回归模型分析年龄与HbA1c之间的关联，并对糖尿病特征、慢性并发症、炎症标志物和红细胞指数进行了调整。基于红细胞分布宽度（RDW）中位数分割进行亚组分析。观察到年龄与HbA1c之间存在显著的负相关，未标准化的B系数（95%置信区间）为-0.112（-0.166；-0.058，P<0.001）。在对糖尿病特征、并发症、炎症标志物和红细胞指数进行调整后，这种关联仍然存在（-0.115，-0.179；-0.051，P = 0.001）。亚组分析表明，与RDW较高的参与者相比，RDW较低的参与者中这种负相关更强（-0.174，-0.269；-0.079，P<0.001），这表明红细胞特征可能会改变这种关系。除了RDW外，未发现显著的相互作用。我们的研究结果揭示了糖尿病患者中年龄与HbA1c之间存在明显的负相关，且独立于糖尿病特征、并发症和炎症标志物。这种关联在RDW水平较低的个体中尤为明显，突出了红细胞形态在糖尿病患者衰老过程中影响HbA1c水平的潜在作用。
