Glycated Hemoglobin (HbA1c) as a Predictor of Outcomes during Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Association between glycated haemoglobin and the risk of chronic obstructive pulmonary disease: A prospective cohort study in UK biobank

AIMS

To investigate the association between glycated haemoglobin (HbA1c) levels and chronic obstructive pulmonary disease (COPD) incidents in the general population, and the association between HbA1c levels and mortality in patients with COPD.

MATERIALS AND METHODS

We investigated the association of HbA1c levels with COPD risk in the general population in the UK Biobank, using data from 420 065 participants. Survival analysis was conducted for 18 854 patients with COPD. We used restricted cubic spline analysis to assess the dose-response relationship between HbA1c levels and COPD risk and survival. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

RESULTS

During a median follow-up of 12.3 years, 11 556 COPD cases were recorded. HbA1c had a non-linear relationship with COPD risk (p for non-linearity < .05). Compared with the quintile 2 (32.2-<34.3 mmol/mol), those with HbA1c levels above 38.7 mmol/mol (quintile 5) had a 22% (HR, 1.22, 95% CI: 1.15-1.30) higher risk of COPD. Compared with the HbA1c decile 2 (30.5-<32.2 mmol/mol), the HRs (95% CI) of COPD risk were 1.16 (1.03-1.30) and 1.36 (1.24-1.50) in the lowest HbA1c decile (<30.5 mmol/mol) and highest decile (≥41.0 mmol/mol), respectively. The increased COPD risk associated with HbA1c was more pronounced in younger, current smokers, passive smokers, and participants with a higher Townsend deprivation index (all p for interaction < .05). Among patients with COPD, 4569 COPD cases died (488 because of COPD) during a median follow-up of 5.4 years. Regarding COPD survival, HbA1c had a non-linear relationship with all-cause death (p for non-linearity < .05). Those with HbA1c quintile 5 (≥38.7 mmol/mol) had a 23% (HR, 1.23, 95% CI: 1.10-1.37) higher risk of all-cause death compared with the quintile 2 (32.2-<34.3 mmol/mol). Compared with the HbA1c decile 4 (33.3-<34.3 mmol/mol), those in the lowest HbA1c decile (<30.5 mmol/mol) and highest HbA1c decile (≥41.0 mmol/mol) had 22% (HR, 1.22; 95% CI: 1.01-1.47) and 28% (HR, 1.28; 95% CI: 1.11-1.48) higher risk for overall death. However, no significant association was observed between HbA1c levels and the risk of COPD-specific death.

CONCLUSIONS

Our findings indicated that lower and higher HbA1c levels were associated with a higher risk of COPD. In COPD cases, lower and higher HbA1c levels were associated with a higher COPD all-cause death risk.

WaveFlex biosensor based on S-tapered and waist-expanded technique for detection of glycosylated hemoglobin

Glycosylated hemoglobin (HbA1c) is considered a new standard for the detection of diabetes mellitus because it is more accurate than regular blood sugar tests and there is no need to take blood on an empty stomach or at a specific time. In this work, we have developed a novel optical fiber biosensor, referred to as the "WaveFlex biosensor," which operates on the principles of localized surface plasmon resonance (LSPR) plasmonic wave. The sensor is fabricated using an innovative S-tapered and waist-expanded technique, enabling it to effectively detect HbA1c. Compared to the HbA1c sensors currently in use, HbA1c optical fiber sensors possess the characteristics of high sensitivity, low cost, and strong anti-interference ability. The gold nanoparticles (AuNPs), cerium oxide (CeO2) nanorods (NRs), and tungsten disulfide (WS2) nanosheets (NSs) are functionalized to improve the effectiveness of the fiber sensor on the probe surface. AuNPs are utilized to generate LSPR by the excitation of evanescent waves to amplify the sensing signal. The CeO2-NRs can have a strong metal-carrier interaction with AuNPs, enhancing the cascade of CeO2-NRs and AuNPs. The WS2-NSs with layered fold structure have a large specific surface area. Therefore, the combination of CeO2-NRs and WS2-NSs is conducive to the binding of antibodies and the addition of sites. The functionalized antibodies on the fiber make the sensor probe capable of specific selection. The developed probe is applied to test the HbA1c solution over concentrations of 0-1000 µg/mL, and the sensitivity and limits of detection of 1.195×10-5 a.u./(µg/mL) and 1.66 µg/mL are obtained, respectively. The sensor probe is also evaluated using assays for reproducibility, reusability, selectivity, and pH. According to the findings, a novel method for detecting blood glucose based on a plasmonic biosensor is proposed.

Elevated Blood Glucose is Associated with Severe Exacerbation of Chronic Obstructive Pulmonary Disease

Background

Methods

Results

Conclusion

The Combination Clinical Value of Plasma Brain Natriuretic Peptide and Serum HbAlc in the Diagnosis of Chronic Pulmonary Heart Disease

Objective. To analyze the combination clinical value of plasma brain natriuretic peptide and serum glycated hemoglobin (HbAlc) in chronic pulmonary heart disease. Methods. A total of 200 patients with chronic pulmonary heart disease admitted to our hospital from January 2021 to January 2022 were selected as the observation group, and 200 healthy subjects were selected as the control group during the same period. All subjects were examined by an ECG vector map and plasma BNP, and HbAlc levels were detected to analyze the value and clinical significance of each index in single diagnosis and combined diagnosis. Results. Plasma BNP and HbAlc levels in the observation group were significantly higher than those in the control group ( $P<0.05$ ). There were 154 BNP positive, 146 HbAlc positive, 164 parallel combined diagnosis positive, and 132 serial combined diagnosis positive. Sensitivity of series combination diagnosis was significantly higher than other indexes ( $P<0.05$ ); especially, parallel combination diagnosis was significantly higher than other indexes ( $P<0.05$ ). Besides, area under the ROC curve of parallel combination diagnosis and series combination diagnosis was significantly higher than that of each index alone diagnosis ( $P<0.05$ ). Conclusion. In the diagnosis of chronic pulmonary heart disease, the combination of plasma BNP and HbAlc can effectively improve the diagnostic specificity and sensitivity, as well as improve the area under the ROC curve.

COPD and Diabetes Mellitus: Down the Rabbit Hole

Abstract:

One of the important comorbidities that has a longstanding research history in COPD is diabetes. Although there are multiple studies on COPD and diabetes, the exact links between these two conditions are still controversial. The exact prevalence of diabetes in COPD varies between 2 and 37 %. The true nature of this relationship is complex and may be partially related to the tradi-tional risk factors for diabetes such as smoking, cardiovascular disease and use of steroids. Howev-er, COPD is a disease that has multiple phenotypes and is no longer regarded as a homogeneous condition. It seems that some COPD patients who overlap with asthma or the obese phenotype are at a particular risk for T2DM. The aim of this review is to analyze the prevalence, risk factors and possible interactions between COPD and diabetes mellitus.