Zheng Wen, Xin Qin-Jie, Wang Xiao-Xia, Li Sheng, Wang Xiao, Nie Shao-Ping
Center for Coronary Artery Disease, Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Geriatric Cardiology, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
J Geriatr Cardiol. 2025 Mar 28;22(3):381-388. doi: 10.26599/1671-5411.2025.03.010.
The relationship between glycated hemoglobin (HbA1c) and cognitive impairment in older adults with coronary heart disease (CHD) remains unclear.
The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing, China. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group (≥ 6.5 mmol/L) and low HbA1c group (< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.
In this study of 3244 participants, 1201 (37.0%) patients were in high HbA1c group and 2045 (63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable (OR = 1.27, 95% CI: 1.15-1.40, < 0.001; OR = 1.79, 95% CI: 1.41-2.26, ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear (p for non-linear = 0.323, < 0.001).
Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.
老年冠心病（CHD）患者糖化血红蛋白（HbA1c）与认知功能障碍之间的关系尚不清楚。
本研究采用前瞻性队列研究设计，纳入了中国北京3244名年龄≥65岁的参与者。采用简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）评估认知功能。入院时检测血清HbA1c。所有患者根据HbA1c水平分为高HbA1c组（≥6.5 mmol/L）和低HbA1c组（<6.5 mmol/L）。采用逻辑回归分析评估HbA1c与认知功能障碍之间的关联。
在这项对3244名参与者的研究中，1201名（37.0%）患者处于高HbA1c组，2045名（63.0%）患者存在认知功能障碍。逻辑回归分析表明，无论HbA1c是连续变量还是分类变量，HbA1c都是认知功能障碍的独立危险因素（OR = 1.27，95%CI：1.15 - 1.40，P < 0.001；OR = 1.79，95%CI：1.41 - 2.26，P ≤ 0.001）。限制立方样条曲线显示HbA1c与认知功能障碍之间的关系呈线性（非线性P = 0.323，P < 0.001）。
老年冠心病患者HbA1c水平升高与认知功能障碍风险增加相关。这些见解可用于提高这些患者群体认知筛查的准确性和敏感性。
