ArticleFrontiers in endocrinology2026
The impact of the traditional Chinese spring festival on glycemic control in a hospital population: a lag time-window analysis of 300,046 HbA1c tests.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Chinese Spring Festival involves marked lifestyle changes that may disrupt glycemic control. However, accurately quantifying its impact on long-term glycemic control measured by HbA1c is methodologically challenging because of the biomarker's 2-3 month reflection period. Objective: This study aimed to quantify the adjusted association of the Spring Festival on HbA1c in a large hospital population by applying a novel "lag time-window" approach that accounts for the inherent lag of HbA1c. Methods: We analyzed 300,046 consecutive HbA1c tests from a tertiary hospital in China (2013-2025). The primary exposure was defined using a 60-day lag window: a test was considered exposed if the test date minus 60 days fell within the lunar Spring Festival week (New Year's Eve to the 6th day). Nonparametric tests and quantile regression were used to adjust for age, gender, season, and department subgroup. Results: The median HbA1c during the lagged Spring Festival week was significantly higher than in the control period (6.1% vs. 6.0%; median difference +0.1%, P<0.001). The effect was most pronounced with the 60-day lag, attenuated at 30 days, and absent at 90 days. Subgroup analysis showed that the increase was concentrated in patients under diabetes core management (Festival week: 6.2% vs. control: 6.1%, P<0.05), with no effect in the general health screening population (P = 0.45). Quantile regression confirmed an independent association (β=0.041, 95% CI: 0.021-0.061, P<0.001). Conclusions: In this hospital-based population, after adjusting for the intrinsic lag of HbA1c, our findings suggest that the Spring Festival is associated with a small but statistically significant worsening of long-term glycemic control, specifically in high-risk patients with established dysglycemia. The pre-festival period should be recognized as a critical window for targeted intervention.
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