Albumin-Corrected Fructosamine Predicts All-Cause and Non-CVD Mortality Among the Very Elderly Aged 80 Years or Older Without Diabetes.

Document Type

Article

Abstract

BACKGROUND: Several guidelines have suggested alternative glycemic markers for hemoglobin A1c among older adults with limited life expectancy or multiple coexisting chronic illnesses. We evaluated associations between fructosamine, albumin-corrected fructosamine (AlbF), fasting plasma glucose (FPG), and mortality in the diabetic and nondiabetic subpopulations, and compared which marker better predicts mortality among participants aged 80 and older.

METHODS: Included were 2 238 subjects from the Healthy Ageing and Biomarkers Cohort Study (2012-2018) and 207 participants had diabetes at baseline. Multivariable Cox proportional hazards regression models investigated the associations of fructosamine, AlbF, FPG, and all-cause, cardiovascular disease (CVD), and non-CVD mortality in the diabetic and nondiabetic subpopulations. Restricted cubic splines explored potential nonlinear relations. C-statistic, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) evaluated the additive value of different glycemic markers to predict mortality.

RESULTS: Overall, 1 191 deaths were documented during 6 793 person-years of follow-up. In the linear model, per unit increases of fructosamine, AlbF, and FPG were associated with a higher risk of mortality in nondiabetic participants, with hazard ratios of 1.02 (1.00, 1.05), 1.27 (1.14, 1.42), and 1.04 (0.98, 1.11) for all-cause mortality, and 1.04 (1.00, 1.07), 1.38 (1.19, 1.59), and 1.10 (1.01, 1.19) for non-CVD mortality, respectively. Comparisons indicated that AlbF better predicts all-cause and non-CVD mortality in nondiabetic participants with significant improvement in IDI and NRI.

CONCLUSIONS: Higher concentrations of fructosamine, AlbF, and FPG were associated with a higher risk of all-cause or non-CVD mortality among the very elderly where AlbF may constitute an alternative prospective glycemic predictor of mortality.

Medical Subject Headings

Aged; Aged, 80 and over; Albumins; Biomarkers; Blood Glucose; Cardiovascular Diseases; Cohort Studies; Diabetes Mellitus; Fructosamine; Glycated Hemoglobin; Humans; Mortality; Prospective Studies; Risk Factors

Publication Date

8-12-2022

Publication Title

The journals of gerontology. Series A, Biological sciences and medical sciences

ISSN

1758-535X

Volume

77

Issue

8

First Page

1673

Last Page

1682

PubMed ID

34758092

Digital Object Identifier (DOI)

10.1093/gerona/glab339

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