Evidence map›Paper›PMID 33464682›Full record

ArticleDiabetes, obesity & metabolism2021

HbA1c and brain health across the entire glycaemic spectrum.

Victoria Garfield, Aliki-Eleni Farmaki, Sophie V Eastwood, Rohini Mathur, Christopher T Rentsch, Krishnan Bhaskaran, Liam Smeeth, Nish Chaturvedi

Erratum issuedOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes, obesity & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 2 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Pooled it
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  3. Resistance training and subcortical vascular cognitive impairment: A 12-month randomized trial.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Victoria GarfieldMRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK.ORCID 0000-0002-5127-0890
Aliki-Eleni FarmakiMRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK.
Sophie V EastwoodMRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK.
Rohini MathurDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Christopher T RentschDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Krishnan BhaskaranDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Liam SmeethDepartment of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Nish ChaturvediMRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, University College London, London, UK.
London School of Hygiene & Tropical Medicine · GBMRC Unit for Lifelong Health and Ageing · GB

Funding

British Heart Foundation 15/0005250Medical Research Council MC_PC_17228Medical Research Council MC_QA137853Wellcome Trust 107731/Z/15/ZWellcome Trust 201375/Z/16/Z
6 · The paper itself

Abstract

aimTo understand the relationship between HbA1c and brain health across the entire glycaemic spectrum. MATERIALS AND

methodsWe used data from the UK Biobank cohort consisting of 500,000 individuals aged 40-69 years. HbA1c and diabetes diagnosis were used to define baseline glycaemic categories. Our outcomes included incident all-cause dementia, vascular dementia (VD), Alzheimer's dementia (AD), hippocampal volume (HV), white matter hyperintensity (WMH) volume, cognitive function and decline. The reference group was normoglycaemic individuals (HbA1c ≥35 & <42 mmol/mol). Our maximum analytical sample contained 449,973 individuals with complete data.

resultsPrediabetes and known diabetes increased incident VD (HR 1.54; 95% CI = 1.04, 2.28 and HR 2.97; 95% CI = 2.26, 3.90, respectively). Known diabetes increased all-cause and AD risk (HR 1.91; 95% CI = 1.66, 2.21 and HR 1.84; 95% CI = 1.44, 2.36, respectively). Prediabetes and known diabetes elevated the risks of cognitive decline (OR 1.42; 1.48, 2.96 and OR 1.39; 1.04, 1.75, respectively). Prediabetes, undiagnosed and known diabetes conferred higher WMH volumes (3%, 22% and 7%, respectively) and lower HV (36, 80 and 82 mm

conclusionBoth prediabetes and known diabetes are harmful in terms of VD, cognitive decline and AD risks, as well as lower HV. Associations appeared to be somewhat driven by antihypertensive medication, which implies that certain cardiovascular drugs may ameliorate some of the excess risk. Low-normal HbA1c levels, however, are associated with more favourable brain health outcomes and warrant more in-depth investigation.

Indexed as

Blood GlucosePrediabetic StateBrainGlycated HemoglobinHumansRisk FactorsBlood GlucoseGlycated Hemoglobincohort studydiabetes complicationsobservational studypopulation studytype 2 diabetes

Identifiers

PMID33464682
PMCPMC8261644
OpenAlexW3122514710

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.