ArticleFrontiers in endocrinology2025
Nonlinear association between glycated hemoglobin levels and mortality in elderly patients with non-diabetic chronic kidney disease: a national health and nutrition examination survey analysis.
Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Bile acids as a predictor for all-cause mortality in peritoneal dialysis patients: a retrospective cohort study.BMC nephrology · 2026Article
- The roles of advanced glycation end products in cardiovascular diseases: from mechanisms to therapeutic strategies.Frontiers in cardiovascular medicine · 2025Review
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6 authors.
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Abstract
Background: The relationship between glycated hemoglobin (HbA1c) levels and mortality outcomes in elderly patients with non-diabetic chronic kidney disease (CKD) has not been well characterized. This study aimed to investigate the correlation between HbA1c levels and all-cause and cardiovascular disease (CVD) mortality in elderly individuals with non-diabetic CKD. Methods: Data from the NHANES (1999-2018) were analyzed to measure HbA1c levels in whole blood using high-performance liquid chromatography (HPLC). Information on deaths and subsequent details was collected through the National Mortality Index until December 31, 2019. Hazard ratios (HR) and 95% confidence intervals (CIs) for all-cause and CVD mortality were calculated using weighted Cox proportional hazards and restricted cubic spline models. Results: Among the 1,931 participants (mean [SE] age, 73.2 [0.2] years; 61.9% female), over a median follow-up period of 7.6 years, a total of 1,003 deaths were observed, including 412 from CVD. HbA1c was divided into four quartiles: Quartile 1 (3.7-5.3%), Quartile 2 (5.4-5.6%), Quartile 3 (5.7-5.8%) as the reference group, and Quartile 4 (5.9-6.4%). Higher risks of all-cause mortality were noted in the lowest and highest HbA1c quartiles, with adjusted HR (95% CI) of 1.48 (1.18-1.87) and 1.31 (1.01-1.70) respectively. For CVD mortality, the lowest quartile showed a significantly increased risk (HR 1.94, 95% CI: 1.29-2.90), but the highest quartile did not significantly differ from the reference, with HR 1.14 (0.73-1.77). The RCS analysis indicated a U-shaped nonlinear relationship between HbA1c levels and all-cause mortality (P = 0.026 for nonlinearity) and a J-shaped nonlinear relationship with CVD mortality (P = 0.035 for nonlinearity). Conclusion: This cohort study suggests that both low and high HbA1c levels are associated with an increased risk of all-cause mortality in elderly patients with non-diabetic CKD.
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