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

Jinhui Zhou, Yuebin Lv, Feng Zhao, Yuan Wei, Xiang Gao, Chen Chen, Feng Lu, Yingchun Liu, Chengcheng Li, Jiaonan Wang, Xiaochang Zhang, Heng Gu, Zhaoxue Yin, Zhaojin Cao, Virginia B. Kraus, Chen Mao, Xiaoming Shi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1673-1682
Number of pages10
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume77
Issue number8
DOIs
StatePublished - Aug 1 2022

All Science Journal Classification (ASJC) codes

  • General Medicine

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