Hemoglobin A1c and Associated Risk Factors in Older Adults
Baseline characteristics of the participants are summarized in Table 1 Men had higher BW, WC, 6-min walking distance, and VO2peak values than women. In contrast, women had higher BMI, lower and upper flexibility, TC, glycemia, and HbA1c values than men. The age, SBP, DBP, HRrest, HRpeak, HDL-C, LDL-C, TG, TG/HDL-C ratio, Log10 hs-CRP, upper and lower strength, and agility and dynamic balance values were similar in men and women.
HbA1c levels ranged from 4.6% to 9.4% with a skewed distribution, with a mean of 5.6%, and 93% of the cases below 6.5%. Considering the wide range of age of the participants (65–95 years), partial correlations were performed controlling for the effect of the sex and age. HbA1c had positive associations with glycemia (r = 0.80; p = 0.00), TG (r = 0.26; p = 0.02), HDL-C (r = −0.31; p = 0.01), TG/HDL-C (r = 0.29; p = 0.01), BW (r = 0.34; p = 0.00), WC (r = 0.33; p = 0.00), and BMI (r = 0.31; p = 0.01). HbA1c did not correlate significantly with any component of functional fitness: upper strength (r = 0.09; p = 0.45), lower strength (r = 0.08; p = 0.51), upper flexibility (r = −0.13; p = 0.86), lower flexibility (r = −0.02; p = 0.89), agility and dynamic balance (r = 0.07; p = 0.54), VO2peak (r = 0.05; p = 0.68). HbA1c also did not associate significantly with TC (r = 0.07; p = 0.52), LDL-C (r = 0.12; p = 0.28), Log10 hs-CRP (r = 0.10; p = 0.39), PAS (r = 0.40; p = 0.73), and PAD (r = 0.04; p = 0.70). Finally, HbA1c did not correlate significantly with age (r = −0.08; p = 0.46).
The prevalence of obesity, using the IDF cut-off points based on WC for European people, was 78% (85% in women and 65% in men), decreasing to 48% (60% in women and 30% in men), and 38% (47% in women and 24% in men) with the USDHHS criteria, using WC and BMI, respectively (Figure 1). HbA1c was compared between obese and non-obese people using the three separate categories of cut-off points (Figure 2). Differences between obese and non-obese participants on HbA1c levels, adjusting for age and sex, were only observed with IDF criteria for waist circumference (5.7 ± 0.8% vs 5.2 ± 0.4%) (F = 3.90, p = 0.05), and not with USDHHS criteria for waist circumference (5.7 ± 0.9% vs 5.4 ± 0.5%) (F = 1.82, p = 0.18), nor BMI (5.8 ± 1.0% vs 5.4 ± 0.5%) (F = 2.21, p = 0.14). The IDF and USDHHS criteria for obesity did not interact with sex and age.
(Enlarge Image)
Figure 1.
Prevalence of obesity with IDF [17]criteria for central obesity (waist circumference of ≥ 80 cm in women, and of ≥ 94 cm in men), and USDHHS [16]criteria (waist circumference of > 88 cm in women men > 102 cm; and BMI ≥ 30 kg/m).
(Enlarge Image)
Figure 2.
Glycated hemoglobin by obesity with cut-off points of IDF [17]on waist circumference and of USDHHS [16]on waist circumference and BMI. § p ≤ 0.05.
Cardiorespiratory fitness is often defined in terms of the VO2peak. The majority of the participants (65%) presented mean values of VO2peak that were 'below average' (68% of women and 60% of men), whereas a smaller proportion (35%) were within 'normal range' (32% of women and 40% of men). None of the participants had 'above average' scores for their respective age group. Figure 3 illustrates HbA1c levels according to the VO2peak level. HbA1c had similar values in older adults below average (5.5% ± 0.7%) and in those within normal range (5.6% ± 0.8%) on VO2peak (F = 0.99; p = 0.32). Given the observed small-to-moderate inverse relationship between VO2peak and BMI (r = −0.18; p = 0.06), the levels of VO2peak were compared again controlling for the BMI. However, once again HbA1c was similar in both below average and within normal range of VO2peak (F = 0.59; p = 0.45).
(Enlarge Image)
Figure 3.
Glycated hemoglobin by aerobic endurance range [22]. § p ≤ 0.05.
Results
Baseline characteristics of the participants are summarized in Table 1 Men had higher BW, WC, 6-min walking distance, and VO2peak values than women. In contrast, women had higher BMI, lower and upper flexibility, TC, glycemia, and HbA1c values than men. The age, SBP, DBP, HRrest, HRpeak, HDL-C, LDL-C, TG, TG/HDL-C ratio, Log10 hs-CRP, upper and lower strength, and agility and dynamic balance values were similar in men and women.
HbA1c levels ranged from 4.6% to 9.4% with a skewed distribution, with a mean of 5.6%, and 93% of the cases below 6.5%. Considering the wide range of age of the participants (65–95 years), partial correlations were performed controlling for the effect of the sex and age. HbA1c had positive associations with glycemia (r = 0.80; p = 0.00), TG (r = 0.26; p = 0.02), HDL-C (r = −0.31; p = 0.01), TG/HDL-C (r = 0.29; p = 0.01), BW (r = 0.34; p = 0.00), WC (r = 0.33; p = 0.00), and BMI (r = 0.31; p = 0.01). HbA1c did not correlate significantly with any component of functional fitness: upper strength (r = 0.09; p = 0.45), lower strength (r = 0.08; p = 0.51), upper flexibility (r = −0.13; p = 0.86), lower flexibility (r = −0.02; p = 0.89), agility and dynamic balance (r = 0.07; p = 0.54), VO2peak (r = 0.05; p = 0.68). HbA1c also did not associate significantly with TC (r = 0.07; p = 0.52), LDL-C (r = 0.12; p = 0.28), Log10 hs-CRP (r = 0.10; p = 0.39), PAS (r = 0.40; p = 0.73), and PAD (r = 0.04; p = 0.70). Finally, HbA1c did not correlate significantly with age (r = −0.08; p = 0.46).
The prevalence of obesity, using the IDF cut-off points based on WC for European people, was 78% (85% in women and 65% in men), decreasing to 48% (60% in women and 30% in men), and 38% (47% in women and 24% in men) with the USDHHS criteria, using WC and BMI, respectively (Figure 1). HbA1c was compared between obese and non-obese people using the three separate categories of cut-off points (Figure 2). Differences between obese and non-obese participants on HbA1c levels, adjusting for age and sex, were only observed with IDF criteria for waist circumference (5.7 ± 0.8% vs 5.2 ± 0.4%) (F = 3.90, p = 0.05), and not with USDHHS criteria for waist circumference (5.7 ± 0.9% vs 5.4 ± 0.5%) (F = 1.82, p = 0.18), nor BMI (5.8 ± 1.0% vs 5.4 ± 0.5%) (F = 2.21, p = 0.14). The IDF and USDHHS criteria for obesity did not interact with sex and age.
(Enlarge Image)
Figure 1.
Prevalence of obesity with IDF [17]criteria for central obesity (waist circumference of ≥ 80 cm in women, and of ≥ 94 cm in men), and USDHHS [16]criteria (waist circumference of > 88 cm in women men > 102 cm; and BMI ≥ 30 kg/m).
(Enlarge Image)
Figure 2.
Glycated hemoglobin by obesity with cut-off points of IDF [17]on waist circumference and of USDHHS [16]on waist circumference and BMI. § p ≤ 0.05.
Cardiorespiratory fitness is often defined in terms of the VO2peak. The majority of the participants (65%) presented mean values of VO2peak that were 'below average' (68% of women and 60% of men), whereas a smaller proportion (35%) were within 'normal range' (32% of women and 40% of men). None of the participants had 'above average' scores for their respective age group. Figure 3 illustrates HbA1c levels according to the VO2peak level. HbA1c had similar values in older adults below average (5.5% ± 0.7%) and in those within normal range (5.6% ± 0.8%) on VO2peak (F = 0.99; p = 0.32). Given the observed small-to-moderate inverse relationship between VO2peak and BMI (r = −0.18; p = 0.06), the levels of VO2peak were compared again controlling for the BMI. However, once again HbA1c was similar in both below average and within normal range of VO2peak (F = 0.59; p = 0.45).
(Enlarge Image)
Figure 3.
Glycated hemoglobin by aerobic endurance range [22]. § p ≤ 0.05.