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. 2023 Jun 12;13(1):9565.
doi: 10.1038/s41598-023-36481-x.

Factors affecting Hemoglobin A1c in the longitudinal study of the Iranian population using mixed quantile regression

Abbas Bahrampour  1   2   3 , Saiedeh Haji-Maghsoudi  4   5
Affiliations

Factors affecting Hemoglobin A1c in the longitudinal study of the Iranian population using mixed quantile regression

Abbas Bahrampour et al. Sci Rep. .

Abstract

Diabetes, a major non-communicable disease, presents challenges for healthcare systems worldwide. Traditional regression models focus on mean effects, but factors can impact the entire distribution of responses over time. Linear mixed quantile regression models (LQMMs) address this issue. A study involving 2791 diabetic patients in Iran explored the relationship between Hemoglobin A1c (HbA1c) levels and factors such as age, sex, body mass index (BMI), disease duration, cholesterol, triglycerides, ischemic heart disease, and treatments (insulin, oral anti-diabetic drugs, and combination). LQMM analysis examined the association between HbA1c and the explanatory variables. Associations between cholesterol, triglycerides, ischemic heart disease (IHD), insulin, oral anti-diabetic drugs (OADs), a combination of OADs and insulin, and HbA1c levels exhibited varying degrees of correlation across all quantiles (p < 0.05), demonstrating a positive effect. While BMI did not display significant effects in the lower quantiles (p > 0.05), it was found to be significant in the higher quantiles (p < 0.05). The impact of disease duration differed between the low and high quantiles (specifically at the quantiles of 5, 50, and 75; p < 0.05). Age was discovered to have an association with HbA1c in the higher quantiles (specifically at the quantiles of 50, 75, and 95; p < 0.05). The findings reveal important associations and shed light on how these relationships may vary across different quantiles and over time. These insights can serve as guidance for devising effective strategies to manage and monitor HbA1c levels.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The distribution of HbA1c levels across the follow-up duration.
Figure 2
Figure 2
Estimated effects (solid line) and 95% confidence intervals (dashed lines) of various variables on HbA1C across different quantiles.
Figure 2
Figure 2
Estimated effects (solid line) and 95% confidence intervals (dashed lines) of various variables on HbA1C across different quantiles.
See this image and copyright information in PMC

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References

    1. Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global trends in diabetes complications: A review of current evidence. Diabetologia. 2019;62:3–16. doi: 10.1007/s00125-018-4711-2. - DOI - PubMed
    1. Peykari N, et al. Diabetes research in Middle East countries; a scientometrics study from 1990 to 2012. J. Res. Med. Sci. 2015;20:253. - PMC - PubMed
    1. International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels: International Diabetes Federation, 2019. https://diabetesatlas.org/en/sections/worldwide-toll-of-diabetes.html. Accessed 17 Oct 2021.
    1. Abrishami Z, Nasli-Esfahani E, Razmandeh R, Larijani B, Bandarian F. Iran diabetes research roadmap (IDRR) study; gap analysis of diabetes complications in Iran: A review article. Iran. J. Public Health. 2017;46:32–38.
    1. Noshad S, Afarideh M, Heidari B, Mechanick JI, Esteghamati A. Diabetes care in Iran: Where we stand and where we are headed. Ann. Glob. Health. 2015;81:839–850. doi: 10.1016/j.aogh.2015.10.003. - DOI - PubMed