The nonlinear association between HbA1c and cognitive impairment in patients with alcohol use disorder

Abstract

Background: Extensive research has indicated that higher levels of glycated hemoglobin (HbA1c) are associated with poor cognitive performance regardless of the presence of diabetes. To our knowledge, the association between HbA1c levels and cognitive decline in patients with alcohol use disorder is not well understood. This study aimed to investigate whether HbA1c was associated with cognitive impairment in patients with alcohol use disorder. Methods: Patients admitted to the Psychiatry Department of the Third Hospital of Quzhou with a confirmed diagnosis of alcohol-related cognitive impairment were recruited between January 2019 and February 2022. Their HbA1c levels were measured, and they completed the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) after at least one week of monitored abstinence from alcohol. Univariate linear regression, multivariate linear regression and generalized additive models (GAMs) were used to investigate the association of HbA1c with MMSE and MoCA scores. Results: In total, 227 patients were included. Univariate and multivariate regression analyses suggested that HbA1c was negatively associated with MMSE and MoCA scores after adjustment for potential confounders (P < 0.05). The GAM analysis revealed that the relationships between the HbA1c level and the MMSE and MoCA scores were bell-shaped. The inflection points were 5.3% and 5.2% for the MMSE and MoCA respectively. Conclusion: The results of this study suggest that HbA1c levels are significantly related to cognitive impairment in patients with alcohol use disorder. Future studies are required to determine the effects of optimal glucose control in people with alcohol use disorder.

Keywords:

• Alcohol use disorder
• cognitive impairment
• glycated hemoglobin
• generalized additive model

Acknowledgments

The authors would like to thank all the people with AUD who participated in this study for their active cooperation, and the colleagues of the Third Hospital of Quzhou who participated in the study.

Author contributions

The authors’ responsibilities were as follows— Mengling Deng: conceived and wrote the first draft of the manuscript; Guoming Wang, Xiaofeng Gao, Yan Wang, Yanfei Ni, Yunyu Chen and Jiating Xucontributed to patient recruitment, cognitive function measures, and data maintenance; Weifeng Jiang performed the statistical analysis and edited and supervised the manuscript; All authors read and approved the final manuscript.

Declaration of conflicting interests

The authors declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Ethics statements

This study was approved by the Ethics Committee of the Third Hospital of Quzhou, China, 2018-12-18, 2018-09. The participants provided their written informed consent to participate in this study.

Additional information

Funding

This research was funded by the Quzhou Science and Technology Guidance Project, Quzhou, Zhejiang, China (No. 2019117).