Abstract
Background: There is a concept of association between whole blood viscosity (WBV) and glycated aemoglobin (HbA1c), but the odds that both biomarkers increase with age are yet to be exhaustively investigated. The aim of this Health records-based study was to determine the correlation of age with HbA1c as well as age and WBV in diabetes patients.
Methods: The setting of this work was a medical General Practice in a regional Australia. De-identified pathology data of diabetes patients, which included HbA1c, routine biochemistry and haematology results were mined. WBV was derived from haematocrit and serum total protein levels. Statistical analyses included comparison of biomarkers between stratified aged-groups, the correlations with age, and the odds ratio of the variables to increase with age.
Results: Age showed a weak negative correlation with HbA1c (r = -0.25), there were odds that HbA1c can increase by 1% in 2-years (p < 0.04). There was weak positive correlation of WBV with age in oldest aged-group (r = 0.27), but a confounding effect of anaemia causing the odds to decrease 1% in 3-years. HbA1c and WBV were moderately positively correlated in patients with good glycaemic control (r = 0.39).
Conclusion: The notion that HbA1c and WBV increase with age requires rethinking, especially for individuals living with diabetes and undergoing treatment. Implications for interpreting the results of these two tests in diabetes research and clinical management is discussed in the context of limitations in low and middle income countries.
Keywords: Age; blood viscosity; diabetes treatment; glycated haemoglobin; associations
Résumé
Contexte : Il existe un concept d’association entre la viscosité du sang total (WBV) et l’hémoglobine glyquée (HbA1c), mais les probabilités que les deux biomarqueurs augmentent avec l’âge ne font pas encore l’objet d’études exhaustives. Le but de cette étude basée sur les dossiers de santé est de déterminer la corrélation de l’âge avec l’HbA1c ainsi que de l’âge et WBV chez les patients diabétiques.
Méthodes : Le cadre de ce travail était une pratique médicale générale dans une région de l’Australie. Des données de pathologie non identifiées de patients diabétiques, comprenant l’HbA1c, les résultats de routine en biochimie et en hématologie, ont été extraites. WBV était dérivé de l’hématocrite et des taux de protéines sériques totales. Les analyses statistiques comprenaient la comparaison de biomarqueurs ntre les groupes d’âge stratifiés, les corrélations avec l’âge et le rapport de cotes des variables pour augmenter avec l’âge.
Résultats : L’âge montrait une faible corrélation négative avec HbA1c (r = -0,25). Il y avait des chances pour que HbA1c augmente de 1% en 2 ans (p<0,04). Il y avait une faible corrélation positive entre WBV et l’âge dans le groupe le plus âgé (r = 0,27), mais un effet de confusion de l’anémie entraînant une diminution de 1% de la probabilité en 3 ans. HbA1c et WBV étaient modérément corrélées positivement chez les patients ayant un bon contrôle glycémique (r = 0,39).
Conclusion : La notion selon laquelle HbA1c et WBV augmentent avec l’âge nécessite de repenser, en particulier pour les personnes atteintes de diabète et en cours de traitement. Les implications pour l’interprétation des résultats de ces deux tests dans la recherche sur le diabète et la gestion clinique sont discutées dans le contexte des limitations dans les pays à revenu faible et intermédiaire.
Mots - clés : âge ; viscosité du sang ; traitement du diabète ; hémoglobine glyquée ; associations
Correspondence: Dr. Uba Nwose, School of Community Health, Charles State University, Orange Campus. NSW Australia. E-mail: cnwose@csu.edu.au
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