Glycosylated Hemoglobin Testing in the National Social Life, Health, and Aging Project

Gregg, Forest T.; O’Doherty, Katie; Schumm, L. Philip; McClintock, Martha K.; Huang, Elbert S.

doi:10.1093/geronb/gbu118

Cited by 5 publications

(3 citation statements)

References 17 publications

(14 reference statements)

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“…For Wave 2, HbA1c assays were conducted using automated ion-exchange high-performance liquid chromatography (IE-HPLC) performed on a Bio-Rad Variant II Hemoglobin Testing System. Both methods are National Glycohemoglobin Standardization Program (NGSP) certified, and between-wave differences in NSHAP HbA1c measurements have been shown to be comparable to those observed in other large, national studies (Gregg et al, 2014). …”

Section: Methodsmentioning

confidence: 54%

“…Second, the change in method of HbA1c ascertainment between waves raises the possibility that HbA1c measurement precision or accuracy changed by wave. However, the two methods have been shown to be comparable with each other within the NSHAP cohort and with gold-standard venous sampling techniques in several studies, suggesting that our use of these measures in both waves is appropriate (Gregg et al, 2014; Lacher et al, 2013; Parkes et al, 1999). Third, exposure error for NO 2 and to a lesser extent PM 2.5 is probable.…”

Section: Discussionmentioning

confidence: 95%

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Associations between long-term exposure to air pollution, glycosylated hemoglobin and diabetes

Honda

Pun

Manjourides

et al. 2017

International Journal of Hygiene and Environmental Health

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BACKGROUND Air pollution exposures have been shown to adversely impact health through a number of biological pathways associated with glucose metabolism. However, few studies have evaluated the associations between air pollution and glycosylated hemoglobin (HbA1c) levels. Further, no studies have evaluated these associations in US populations or investigated whether associations differ in diabetic as compared to non-diabetic populations. To address this knowledge gap, we investigated the associations between airborne fine particulate matter (PM2.5) and nitrogen dioxide (NO2) and HbA1c levels in both diabetic and non-diabetic older Americans. We also examined the impact of PM2.5 and NO2 on prevalent diabetes mellitus (DM) in this cohort. METHODS We used multilevel logistic and linear regression models to evaluate the association between long-term average air pollutant levels and prevalence of DM and HbA1c levels, respectively, among 4,121 older (57+ years) Americans enrolled in the National Social Life, Health, and Aging Project between 2005 and 2011. All models adjusted for age, sex, body mass index, smoking status, race, household income, education level, neighborhood socioeconomic status, geographic region, urbanicity and diabetic medication use. We estimated participant-specific exposures to PM2.5 on a six-kilometer grid covering the conterminous U.S. using spatio-temporal models, and to NO2 using nearest measurements from the Environmental Protection Agency’s Air Quality System. HbA1c levels were measured for participants in each of two data collection waves from dried blood spots and log-transformed prior to analysis. Participants were considered diabetic if they had HbA1c values ≥ 6.5% or reported taking diabetic medication. RESULTS The prevalence of diabetes at study entry was 22.2% (n=916) and the mean HbA1c was 6.0 ± 1.1%. Mean one-year moving average PM2.5 and NO2 exposures were 10.4 ± 3.0 μg/m3 and 13.1 ± 7.0 ppb, respectively. An inter-quartile range (IQR, 3.9 μg/m3) increase in one-year moving average PM2.5 was positively associated with increased diabetes prevalence (prevalence odds ratio, POR 1.35, 95% CI: 1.19, 1.53). Similarly, an IQR (8.6 ppb) increase in NO2 was also significantly associated with diabetes prevalence (POR 1.27, 95% CI: 1.10, 1.48). PM2.5 (1.8% ± 0.6%, p<0.01) and NO2 (2.0% ± 0.7%, p<0.01) exposures were associated with higher HbA1c levels in diabetic participants, while only NO2 was significantly associated with HbA1c in non-diabetic participants (0.8% ± 0.2%, p<0.01). Significant dose response relationships were identified for both pollutants in diabetic participants and for NO2 in non-diabetic participants. CONCLUSIONS/INTERPRETATIONS In a cohort of older men and women in the United States, PM2.5 and NO2 exposures were significantly associated with prevalence of DM and increased HbA1c levels among both non-diabetic and diabetic participants. These associations suggest that air pollution could be a key risk factor for abnormal glucose metabolism and diabetes in the elde...

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Section: Methodsmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 95%

Associations between long-term exposure to air pollution, glycosylated hemoglobin and diabetes

Honda

Pun

Manjourides

et al. 2017

International Journal of Hygiene and Environmental Health

View full text Add to dashboard Cite

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“…The paired samples not only provide an important check on the quality of the measurements but also provide insurance in situations like the example of HPLC-based measures of HbA1c described above. Moreover, as noted by Gregg et al (2014), a validated cross-walk between DBS and venous blood values collected from each wave of a study will facilitate longitudinal analyses of DBS-based results.…”

Section: Resultsmentioning

confidence: 99%

HPLC-based Measurement of Glycated Hemoglobin using Dried Blood Spots Collected under Adverse Field Conditions

Thomas

Seeman

Potter

et al. 2018

Biodemography and Social Biology

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Glycated hemoglobin (HbA1c) measured using high-performance liquid chromatography (HPLC) assays with venous blood and dried blood spots (DBS) are compared for 143 paired samples collected in Aceh, Indonesia. Relative to gold-standard venous-blood values, DBS-based values reported by the HPLC are systematically upward biased for HbA1c<8% and the fraction diabetic (HbA1c ≥ 6.5%) is overstated almost five-fold. Inspection of chromatograms from DBS assays indicates the % glycosylated calculated by the HPLC excludes part of the hemoglobin A which is misidentified as a hemoglobin variant. Taking this into account, unbiased DBS-based values are computed using data from the machine-generated chromatograms. When the DBS are collected in a clinic-like setting, under controlled humidity/temperature conditions, the recalculated values are almost identical to venous-based values. When DBS are collected under field conditions, the recalculated values are unbiased, but only about half the HbA1c values are measured reliably, calling into question the validity of the other half. The results suggest that collection conditions, particularly humidity, affect the quality of the DBS-based measures. Cross-validating DBS-based HbA1c values with venous samples collected under exactly the same environmental conditions is a prudent investment in population-based studies.

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Reexamining the Classification of Older Adults With Diabetes by Comorbidities and Exploring Relationships With Frailty, Disability, and 5-year Mortality

Leung

Wroblewski

Schumm

et al. 2021

The Journals of Gerontology: Series A

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Background Limited research has been conducted to risk stratify older adults with diabetes. Our objective was to re-examine the 2005-06 classification systems in participants who are now five years older. Methods We examined a subsample of 884 community-residing older adults with the diagnosis of diabetes from the National Social Life, Health, and Aging Project (NSHAP). The primary objective was to utilize a latent class analysis (LCA) to fit a model to 11 comorbidities, comparing the 2010-11 LCA model to that of 2005-6. The secondary objective was to evaluate the association of the identified classes with frailty, disability, and five-year mortality. Results Both 2005-6 LCA and the 2010-11 LCA model fit three similar comorbidity profiles: Class 1 with the lowest rates of nearly all comorbidities, Class 2 had highest rates of obesity, hypertension, arthritis, and incontinence, and Class 3 had the higher rates of myocardial infarctions, congestive heart failure, and stroke. When compared to the healthier Class 1 (class probability=0.67), participants with a comorbidity profile with more prevalent cardiovascular conditions (Class 3; 0.09) were at higher risk of frailty and mortality, but not disability; whereas participants with a comorbidity profile with more prevalent geriatric syndrome conditions (Class 2; 0.24) were at higher risk of frailty and disability, but not mortality. Conclusions We reconfirmed three latent-classes with distinct comorbidity profiles among older adults with diabetes. However, the complex relationships between comorbidity classes with frailty, disability, and mortality will likely require revision of the current rationale for stratified goal setting and treatment selection.

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Glycosylated Hemoglobin Testing in the National Social Life, Health, and Aging Project

Cited by 5 publications

References 17 publications

Associations between long-term exposure to air pollution, glycosylated hemoglobin and diabetes

Associations between long-term exposure to air pollution, glycosylated hemoglobin and diabetes

HPLC-based Measurement of Glycated Hemoglobin using Dried Blood Spots Collected under Adverse Field Conditions

Reexamining the Classification of Older Adults With Diabetes by Comorbidities and Exploring Relationships With Frailty, Disability, and 5-year Mortality

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