Paradoxical Relationship Between Glycated Hemoglobin and Longitudinal Change in Physical Functioning in Older Adults: A Prospective Cohort Study

Wu, I-Chien; Hsu, Chih‐Cheng; Chen, Ching-Yu; Chuang, Shu‐Chun; Cheng, Chiu-Wen; Hsieh, Wan-Shan; Wu, Ming–Shiang; Liu, Yen-Tze; Liu, Yo-Hann; Tsai, Tsung-Lung; Lin, Cheng-Chih; Hsiung, Chao A.

doi:10.1093/gerona/gly147

Cited by 9 publications

(9 citation statements)

References 37 publications

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“…Serum uric acid was not correlated to PD progression in this cohort, in contrast to previous studies which reported that low levels of serum uric acid associated with a high risk of PD progression and worsening of UPDRS scores [ 54 , 55 ]. Moreover, HbA1c was not correlated to PD progression in this study in agreement with the uncertainty about the role of HbA1c to predict PD progression in previous studies [ 56 ]. Younger age, shorter duration of our cohort, small sample size and short duration of follow-up should be considered when interpreting the current findings.…”

Section: Discussionsupporting

confidence: 89%

Baseline predictors of progression of Parkinson’s disease in a sample of Egyptian patients: clinical and biochemical

Helmy

Hamid

Salama

et al. 2022

Egypt J Neurol Psychiatry Neurosurg

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Background Clinical progression of Parkinson’s disease (PD) is highly heterogeneous, and its predictors are generally lacking. Identifying predictors of early disease progression is important for patients’ management and follow-up. The current study aims to identify clinical, neuroimaging and biochemical baseline predictors of motor progression in patients with PD. Forty-five PD patients were assessed at baseline, 6 months and 1 year using MDS-UPDRS total and subscores, Hoehn and Yahr (H&Y), Schwab and England (S&E), International Physical Activity Questionnaire (IPAQ). Baseline New Freezing of Gait Questionnaire (NFOG-Q), Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT), and Time Up and Go Test (TUG), Non-Motor Symptoms Scale (NMSS), Beck Depression Inventory (BDI), PD questionnaire 39 (PDQ-39), MRI brain, uric acid, lipid profile and glycated hemoglobin were performed. Results Significant worsening of MDS-UPDRS total, part III scores, H&Y, S&E and IPAQ (p < 0.001) was detected. One-year progression of H&Y and S&E were significantly correlated to disease duration (p = 0.014, p = 0.025, respectively). Progression of H&Y was correlated to baseline TUG (p = 0.035). S&E progression was correlated to baseline MDS-UPDRS total score (rho = 0.478, p = 0.001) and part III (rho = 0.350, p = 0.020), H&Y (rho = 0.401, p = 0.007), PIGD (rho = 0.591, p < 0.001), NFOG-Q (rho = 0.498, p = 0.001), and TUG (rho = 0.565, p = 0.001). Using linear regression, there was no predictors of clinical progression among the used baseline variables. Conclusion Despite the significant motor and physical activity progression over 1 year that was correlated to baseline motor and gait severity, but without predictive value, further similar and longitudinal studies are warranted to detect predictors of early progression and confirm findings.

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Section: Discussionsupporting

confidence: 89%

Baseline predictors of progression of Parkinson’s disease in a sample of Egyptian patients: clinical and biochemical

Helmy

Hamid

Salama

et al. 2022

Egypt J Neurol Psychiatry Neurosurg

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“…Simllar to our study finding, a previous investigation showed a signifcant decrease in HbA level in thalassemia patients [44]. Low HbA levels were related to a decline in physical function in beta-thalassemia patients, which was associated with elevated IL-6 levels [45]. IL-6 levels in the plasma of thalassemia patients appear to be correlated with fetal hemoglobin; increasing IL-6 levels lead to decreased fetal anemia [46].…”

Section: Discussionsupporting

confidence: 77%

The association between plasma IL-6 levels and several thalassemia-related clinical features in Iraqi patients

Abd-AlKareem

Lafta

Alwan³

2022

ijhs

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The present study was set to investigate the potential association between the level of Interleukin-6 (IL-6), as a key component of the pro-inflammatory response, with different thalassemia’s biological and clinical features. For this purpose, one hundred fifty blood samples were collected from 100 beta-thalassemia patients, who attended the Genetic Hematology Centre at Ibn Al- Baladi Hospital in Baghdad, Iraq, and 50 healthy subjects who were employed as a control group. IL-6 levels were estimated using an ELISA Kit, whereas other thalassemia-related clinical features (such as HbA, HbF, ferritin, blood transfusions, splenectomy status, and the history of frequent infection) were additionally assessed. The results of the present study showed a significant elevation (P≤0.01) in the levels of IL-6 in thalassemia patients as compared to healthy controls (57.7763± 8.94837 vs. 6.3059± 1.90364 pg/ml, respectively). Furthermore, IL-6 plasma levels seem to be influenced by the number of multiple scheduled blood transfusions, with the higher IL-6 mean level corresponding to the more frequent transfusions. Also, splenectomized thalassemia patients showed significantly higher IL-6 levels than those of non-splenectomized patients (61.2687±9.30688 vs. 56.9571±8.71926 pg/ml, respectively).

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“…Also, DM has previously been associated with gait and balance impairment, and insulin resistance in non‐diabetic individuals has been correlated with decreased gait speed 25 . Interestingly, high as well as low HbA1c levels have previously been reported to predict faster physical functioning decline and were also associated with increased interleukin‐6 levels in a community‐based longitudinal study 26 . Chronic inflammation is a hallmark of biological aging, 27 and the cross‐talk between glycometabolic derangement and inflammatory response has been suggested to be involved in physical functioning decline 28 .…”

Section: Discussionmentioning

confidence: 96%

“…25 Interestingly, high as well as low HbA1c levels have previously been reported to predict faster physical functioning decline and were also associated with increased interleukin-6 levels in a community-based longitudinal study. 26 Chronic inflammation is a hallmark of biological aging, 27 and the cross-talk between glycometabolic derangement and inflammatory response has been suggested to be involved in physical functioning decline. 28 Both enhancement of insulin resistance, 28 followed by increased HbA1c and muscle mass and function loss, as well as increased glucose uptake by peripheral tissues 29,30 and decreased HbA1c levels, followed also by muscle weakness and loss of function, may be plausible mechanisms of physical deterioration in aging.…”

Section: Discussionmentioning

confidence: 99%

Euglycemia Indicates Favorable Motor Outcome in Parkinson's Disease

et al. 2021

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Background: The interplay between glycemic control and Parkinson's disease (PD) has long been recognized but not fully understood. Objectives: To investigate the association of glycated hemoglobin (HbA1c) levels with motor and cognitive symptom progression in a prospective PD cohort. Methods: Of 244 PD patients, 17 had low HbA1c (≤30 mmol/mol), 184 were euglycemic (HbA1c 31-41 mmol/mol), 18 had high HbA1c (HbA1 ≥42 mmol/mol), and 25 had diabetes mellitus (DM). Survival analysis was applied on time until Hoehn and Yahr stage ≥3 (motor outcome) and until mild cognitive impairment. Results: Low HbA1c (HR 2.7; 95% CI 1.3-6; P = 0.01) as well as high HbA1c (HR 3.6; 95% CI 1.5-8.9; P = 0.005) but not DM were independent predictors of unfavorable motor outcome. Conclusions: Both high and low HbA1c levels may be associated with motor symptom progression in PD; however, further studies are needed to confirm these findings and increase understanding regarding causality.

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Paradoxical Relationship Between Glycated Hemoglobin and Longitudinal Change in Physical Functioning in Older Adults: A Prospective Cohort Study

Cited by 9 publications

References 37 publications

Baseline predictors of progression of Parkinson’s disease in a sample of Egyptian patients: clinical and biochemical

Baseline predictors of progression of Parkinson’s disease in a sample of Egyptian patients: clinical and biochemical

The association between plasma IL-6 levels and several thalassemia-related clinical features in Iraqi patients

Euglycemia Indicates Favorable Motor Outcome in Parkinson's Disease

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