Association of GA/HbA1c ratio and cognitive impairment in subjects with type 2 diabetes mellitus

Kinoshita, Tomoe; Shimoda, Masashi; Sanada, Junpei; Fushimi, Yoshiro; Hirata, Yurie; Irie, Shintaro; Tanabe, Akihito; Obata, Atsushi; Kimura, Tomohiko; Hirukawa, Hidenori; Kohara, Kenji; Tatsumi, Fuminori; Kamei, Shinji; Nakanishi, Shuhei; Mune, Tomoatsu; Kaku, Kohei; Kaneto, Hideaki

doi:10.1016/j.jdiacomp.2016.08.008

Cited by 25 publications

(23 citation statements)

References 14 publications

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“…In this study, we found significant positive associations of GA/HbA1c with cognitive dysfunction and IADL decline. The former result is compatible with the result of a previous study by Kinoshita et al (2016), which showed that GA/HbA1c is associated with MMSE and the Revised Hasegawa Dementia Scale. However, to our knowledge, this is the first report showing an association between glucose variability and functional decline in elderly patients with DM.…”

Section: Discussionsupporting

confidence: 92%

White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio

Tamura

Kimbara

Yamaoka

et al. 2017

Front. Aging Neurosci.

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Aims: Although evidence has accumulated that white matter hyperintensity (WMH) is associated with the deterioration of cognitive function and impairment of activities of daily living (ADL), the clinical relevance of WMH in elderly patients with diabetes mellitus (DM) is not still clear. The aim of this study was to examine whether WMH volume is associated with ADL and cognitive function and whether glucose control and glucose variability can affect WMH volume in these patients.Methods: This cross-sectional study investigated the associations of WMH with cognitive function and instrumental ADL (IADL), as well as metabolic and vascular risk factors in a total of 178 elderly patients with diabetes. The study assessed WMH volumes and the functional status of cognition and IADL. WMH volumes were evaluated by obtaining axial T2-weighted and fluid-attenuated inversion recovery sequence images on brain magnetic resonance imaging and assessing the images using Software for Neuro-Image Processing in Experimental Research.Results: We found a significant association between WMH volumes and Mini-Mental State Examination (MMSE) scores (p = 0.039) and between WMH and IADL status (p = 0.006). Furthermore, we found significant relations of large WMH volumes with a high glycoalbumin/glycohemoglobin ratio (GA/HbA1c) (p < 0.001). Large WMH volumes were also found to be associated with a low body mass index (p = 0.014) and a low diastolic blood pressure (p = 0.024), but not with HbA1c. Multiple regression analysis showed that high GA/HbA1c, which reflects high glucose variability, was a significant determining factor for large WMH volumes. We also found that GA/HbA1c was negatively associated with both MMSE (p = 0.036) and IADL (p < 0.001).Conclusion: GA/HbA1c, which is a marker of glucose variability, was independently associated with WMH volumes, which could lead to the decline of cognition and IADL in elderly patients with DM.

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Section: Discussionsupporting

confidence: 92%

White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio

Tamura

Kimbara

Yamaoka

et al. 2017

Front. Aging Neurosci.

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“…In addition, the GA/HbA1c ratio is reported to be an indicator that reflects glucose variability [34]. Actually, it reported that GA correlates with diabetic complications such as retinopathy progression [35], neuropathy [36] and cardiovascular disease [37,38], and the GA/HbA1c ratio correlates with cognitive impairment [39]. In this study, GA was associated with oxidative stress in patients with HbA1c C 8% by multivariate analysis.…”

Section: Relationship Of D-roms With Markers Of Diabetic Control and mentioning

confidence: 51%

Association of Hemoglobin A1c, 1,5-Anhydro-d-Glucitol and Glycated Albumin with Oxidative Stress in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study

et al. 2020

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Introduction: Oxidative stress plays a central role in the development and progression of vascular complications in patients with type 2 diabetes mellitus (T2DM). We have previously shown that markers of glucose variability evaluated by continuous glucose monitoring (CGM) are positively associated with oxidative stress in patients with T2DM. However, the evaluation of the glycemic variability by CGM remains a time-and money-consuming procedure. Therefore, this study investigated the independent correlates of oxidative stress among various other clinical markers routinely measured in primary care. Methods: This was a retrospective cross-sectional study with 234 T2DM patients to examine which clinical variables, including 1,5anhydro-D-glucitol (1,5-AG) and glycated albumin (GA), were independently associated with oxidative stress. Oxidative stress was measured using the diacron-reactive oxygen metabolites (d-ROMs) test. The relationships between d-ROMs and clinical factors, such as blood glucose, glycated hemoglobin (HbA1c), 1,5-AG, GA, lipid parameters, and blood pressure, were examined. Results: Multiple stepwise regression analysis revealed that 1,5-AG (inversely), GA, triglycerides, use of metformin and being female were independently associated with d-ROMs. When patients with T2DM were stratified into two groups with HbA1c \ 8.0% and HbA1c C 8.0%, 1,5-AG (inversely), HbA1c, use of metformin and being female were independently associated with d-ROMs in diabetes patients with HbA1c \ 8.0%, whereas GA, fasting plasma Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11605017.

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“…Besides these, factors such as older age, female, higher HbA1c level, DM duration and poorer education were correlated with severe cognitive decline in diabetic patients in other studies [ 14 , 15 – 17 ]. Study from Kinoshita et al [ 18 ] also revealed that glycol-albumin(GA)/HbA1c ratio might be an easy and helpful biomarker for cognitive performance in 88 elderly Japanese diabetic patients. Meanwhile, some studies reported that the fluctuation of glucose level was related to cognition function.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies

Zhao

Han

et al. 2017

Oncotarget

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Diabetes mellitus is considered as an important factor for cognitive decline and dementia in recent years. However, cognitive impairment in diabetic patients is often underestimated and kept undiagnosed, leading to thousands of diabetic patients suffering from worsening memory. Available reviews in this field were limited and not comprehensive enough. Thus, the present review aimed to summarize all available clinical studies on diabetic patients with cognitive decline, and to find valuable biomarkers that might be applied as diagnostic and therapeutic targets of cognitive impairment in diabetes. The biomarkers or risk factors of cognitive decline in diabetic patients could be classified into the following three aspects: serum molecules or relevant complications, functional or metabolic changes by neuroimaging tools, and genetic variants. Specifically, factors related to poor glucose metabolism, insulin resistance, inflammation, comorbid depression, micro-/macrovascular complications, adipokines, neurotrophic molecules and Tau protein presented significant changes in diabetic patients with cognitive decline. Besides, neuroimaging platform could provide more clues on the structural, functional and metabolic changes during the cognitive decline progression of diabetic patients. Genetic factors related to cognitive decline showed inconsistency based on the limited studies. Future studies might apply above biomarkers as diagnostic and treatment targets in a large population, and regulation of these parameters might shed light on a more valuable, sensitive and specific strategy for the diagnosis and treatment of cognitive decline in diabetic patients.

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Association of GA/HbA1c ratio and cognitive impairment in subjects with type 2 diabetes mellitus

Cited by 25 publications

References 14 publications

White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio

White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio

Association of Hemoglobin A1c, 1,5-Anhydro-d-Glucitol and Glycated Albumin with Oxidative Stress in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study

Biomarkers for cognitive decline in patients with diabetes mellitus: evidence from clinical studies

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