Hemoglobina Glicada A1c (HbA1c) e desempenho físico em idosos de diferentes contextos epidemiológicos de envelhecimento - resultados longitudinais do International Mobility in Aging Study (IMIAS)

Abstract

Introduction: Glycated Hemoglobin A1c refers to a blood marker that reflects glucose levels in the body for up to 3 months prior to assessment. The relationship between Hemoglobin A1c (HbA1c) and physical performance in older people has been discussed but has not yet been clearly established. The evaluation of some measures becomes fundamental in the global assessment of the health of the older people, especially regarding physical functioning. The International Mobility in Aging Study (IMIAS) offers a valuable opportunity to analyze the relationship between HbA1c levels and physical performance in older people, as it holds a range of information obtained from biochemical and functional analyses. Objectives and Hypotheses: This study aimed to evaluate the longitudinal relationship between HbA1c and physical performance scores in different epidemiological contexts of aging. Our hypothesis is that high levels of HbA1c may cause decreased physical performance in this population, considering possible influences of gender and sociodemographic aspects. Methods: Longitudinal data of 1,337 older people from three countries (Canada, Brazil, and Colombia) from IMIAS were used to assess the relationship between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Linear Mixed Models grouped by sex and adjusted by Age, Study site, Chronic Conditions, Anthropometric Measures, and Inflammatory Level were used to estimate the influence of HbA1c on SPPB scores, adjusted by covariates. Results: At the IMIAS baseline, Latin American (LA) cities had higher HbA1c averages compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ± 1.49; 6,56 ± 1.70 respectively). SPPB scores were significantly lower in LA cities, and older people in Natal had lower SPPB averages in men (9.67 ± 2.38; p-value < 0.05) and women (8.52 ± 2.33; p-value <0.05). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (β = -0.25, 95% CI: -0.39 to -0.12, p-value = 0.02) but not in women. Conclusions: High HbA1c levels at IMIAS baseline were longitudinally associated with reductions in SPPB scores of older people from different countries, however this association was observed only in men and not in women in the fully adjusted regression models. This study highlights a possible influence of gender on this relationship.