HbA1c vs fasting glucose and cardiometabolic multimorbidity in older English adults
In 2233 older English adults free of four cardiometabolic conditions at baseline, higher HbA1c and fasting glucose were each associated with later cardiometabolic multimorbidity; HbA1c was the stronger marker. [1]
Automatic summary · not editorially reviewed
The key findings
The cohort comprised 2233 adults (mean age 63; 45.2% men) free of hypertension, coronary disease, diabetes and stroke at baseline in 2008-2009. [1]
Over 12-15 years, 129 participants developed cardiometabolic multimorbidity; higher HbA1c and FPG were each associated with higher risk, and HbA1c more strongly. [1]
Adding HbA1c to established risk factors improved discrimination, and HbA1c was described as a substantially stronger and more informative marker than FPG. [1]
The source at a glance
- Study type / format
- Observational cohort analysis (English Longitudinal Study of Ageing)
- Population / context
- 2233 adults in England, mean age 63, free of hypertension, coronary disease, diabetes and stroke at baseline.
- Summary based on
- Study abstract
- Original publication
- September 12, 2026
2233 older English adults without four conditions
The English Longitudinal Study of Ageing followed 2233 adults (mean age 63; 45.2% men) who at baseline (wave 4, 2008-2009) had no hypertension, coronary disease, diabetes or stroke. The researchers asked how two glycemic markers, glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG), related to later cardiometabolic multiple long-term conditions, meaning at least two of these conditions. New cases were assessed at wave 10 (2021-2023). This is an observational cohort analysis, so the associations do not show that either marker causes the conditions.
Supporting source [1]
129 new cases over 12-15 years
Over 12-15 years, 129 participants developed cardiometabolic multimorbidity (57.8 per 1000; 95% confidence interval 48.5-68.3). The analyses showed continuous, dose-response associations for both markers. Each 1% higher HbA1c was associated with an odds ratio of 1.99 (95% CI 1.51-2.63); the highest versus lowest HbA1c tertile had an odds ratio of 3.15 (95% CI 2.00-4.94). FPG associations were more modest: per 1 mmol/L, odds ratio 1.39 (95% CI 1.18-1.64); highest versus lowest tertile, 1.98 (95% CI 1.23-3.19). The FPG associations weakened after mutual adjustment.
Supporting source [1]
HbA1c improved prediction more than FPG
Adding HbA1c to established risk factors improved discrimination (change in C-index 0.0344; P=.017 for the between-marker comparison). The abstract reports that HbA1c emerged as a substantially stronger and more informative marker than FPG. These are predictive-performance findings from one cohort, not evidence that measuring HbA1c prevents disease. The abstract does not report how the cohort was recruited in detail, how many participants were excluded, or whether the results hold in other populations; the full text was not reviewed.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This is an observational cohort, so associations are not causal. The abstract does not detail recruitment, exclusions or applicability to other populations.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Seidu S, Kunutsor SK, Khunti K. · europepmc.org · September 12, 2026