LAUSR

AIMS The association between hemoglobin A1c (HbA1c) and cerebral microbleeds (CMBs) remains unclear. We aimed to investigate the association between HbA1c and CMBs in community-based individuals without stroke or transient ischemic attack (TIA) and whether this association differs between individuals with and without diabetes mellitus (DM). MATERIALS AND METHODS All individuals were recruited from a community in Beijing, China from January 2015 to September 2019. All individuals completed a questionnaire and underwent blood tests and brain magnetic resonance imaging. A susceptibility-weighted imaging sequence was acquired to detect CMBs, which were defined as small, round, and low-signal lesions with <10 mm diameter. The association between HbA1c and CMBs was analyzed using multivariable logistic regression adjusted for demographics, medical history, and blood sample test results. Subgroup analyses stratified by history of DM were performed. RESULTS CMBs were detected in 119 (21.88%) individuals. HbA1c was independently associated with CMBs (odds ratio [OR], 1.51; 95% confidence interval [CI], 1.03-2.22). In 87 patients with DM, multivariable logistic analysis showed that HbA1c was significantly associated with CMBs (OR, 1.67; 95% CI, 1.04-2.69), whereas in individuals without DM, no significant association was observed between HbA1c and CMBs (OR, 1.07; 95% CI, 0.50-2.30). CONCLUSIONS HbA1c was associated with CMBs in individuals without stroke or TIA, particularly in individuals with DM, suggesting that the status of glycemic control warrants attention for the prevention of CMBs. It would be beneficial to manage HbA1c specifically to control the risk of CMBs, especially in individuals with DM. This article is protected by copyright. All rights reserved.