Glycated Haemoglobin (HbA1c) and Future Physical and Mental Functional Health in the European Prospective Investigation into Cancer (EPIC)-Norfolk Population-Based Study

Fiona McLachlan; Alexandra Johnstone; Phyo Kyaw Myint

doi:10.3390/jpm13091336

Glycated Haemoglobin (HbA1c) and Future Physical and Mental Functional Health in the European Prospective Investigation into Cancer (EPIC)-Norfolk Population-Based Study

Fiona McLachlan^* (Corresponding Author), Alexandra Johnstone, Phyo Kyaw Myint

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Little is understood about the relationship between glycated haemoglobin and future functional health in the general population. In this work, we aimed to assess if glycaemic control is associated with future physical and mental functional health at 18-month follow-up in a UK general population, in those with and without diabetes. This work was a cross-sectional study. Between 1995 and 1997, participants of the European Prospective Investigation into Cancer, Norfolk, attended a health check including blood testing for haemoglobin A1c (HbA1c) and completed a health and lifestyle questionnaire. Eighteen months later, self-reported physical and mental functional health were assessed using short form-36 (SF-36). Outcomes of interest included physical and mental component summary (PCS and MCS, respectively) scores of the SF-36. A total of 7343 participants (56% women, mean (SD) 58.1 ± 9.5 years) were eligible to be included, of whom 167 had prevalent diabetes. In our linear regression analysis, a higher HbA1c (mmol/mol) was found to be associated with a poorer PCS score (coefficient −0.15 (p < 0.0001)) at follow-up. After adjustment for comorbid conditions, including obesity, this association was no longer statistically significant. A higher HbA1c (mmol/mol) was associated with a better MCS score at follow-up; this finding was significant when adjusted for comorbid conditions (coefficient 0.029 (p < 0.05)). Our findings suggest that the association between a higher HbA1c and poorer physical functional health is explained by a higher BMI and comorbidity status in a general population. While higher HbA1c was found to be associated with higher mental functional health at follow-up, the magnitude of this association was small. Healthy responder bias and unmeasured confounding variables may have influenced this result; thus, it should be interpreted with caution.

Original language	English
Article number	1336
Number of pages	9
Journal	Journal of Personalized Medicine
Volume	13
Issue number	9
Early online date	30 Aug 2023
DOIs	https://doi.org/10.3390/jpm13091336
Publication status	Published - 30 Aug 2023

Bibliographical note

Funding
The EPIC-Norfolk study (DOI 10.22025/2019.10.105.00004) has received funding from the Medical Research Council (grant number MR/N003284/1 and MC-UU_12015/1) and Cancer Research UK (grant number C864/A14136).
Acknowledgments
We are grateful to the participants of the EPIC-Norfolk study who have been part of this project, and to the many members of the study teams at the University of Cambridge who have enabled this research. We gratefully acknowledge the EPIC management committee for their approval for data use for this study.

Data Availability Statement

Data are available upon request, with applications made to the EPIC-Norfolk steering committee for consideration.

Keywords

diabetes
health-related quality of life
epidemiology
functional health
glycated haemoglobin

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative CommonsAttribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Cite this

Glycated Haemoglobin (HbA1c) and Future Physical and Mental Functional Health in the European Prospective Investigation into Cancer (EPIC)-Norfolk Population-Based Study. / McLachlan, Fiona (Corresponding Author); Johnstone, Alexandra ; Myint, Phyo Kyaw.
In: Journal of Personalized Medicine, Vol. 13, No. 9, 1336, 30.08.2023.

Research output: Contribution to journal › Article › peer-review

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Glycated Haemoglobin (HbA1c) and Future Physical and Mental Functional Health in the European Prospective Investigation into Cancer (EPIC)-Norfolk Population-Based Study

Abstract

Bibliographical note

Data Availability Statement

Keywords

UN SDGs

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