Temporal Distribution of Elevated-HbA1c Records and a Young-Adult Multiorgan Biomarker Profile in Diabetes: A Retrospective Observational Study

Background/Objectives: Diabetes-related renal, lipid, and hepatic abnormalities are clinically important, but their distribution may be heterogeneous and is not fully represented by HbA1c alone. We characterized the temporal age and sex composition of elevated-HbA1c records and, separately, the multiorgan biomarker profile of a 2022 young-adult subcohort. Methods: This retrospective observational study analyzed 1160 patient-year records classified as having elevated HbA1c from 2019–2022. These were annual record strata rather than 1160 unique individuals or a cohort followed as participants aged. A separate cross-sectional biomarker subcohort comprised 49 adults aged 18–29 years in 2022, of whom 26 were source-classified as having elevated HbA1c. Annual age and sex distributions were assessed using chi-square tests. Biomarker abnormalities were summarized with biomarker-specific denominators and Wilson 95% confidence intervals; sex comparisons were exploratory and used Fisher’s exact tests, odds ratios, φ coefficients, and Benjamini–Hochberg false-discovery-rate correction. Results: Age composition differed across calendar years (χ2[6] = 45.02, p < 0.001; Cramér’s V = 0.139), with adults aged ≥60 years accounting for 50.0% of elevated-HbA1c records in 2022. Sex composition also varied (χ2[3] = 19.47, p < 0.001; Cramér’s V = 0.130). In the young-adult biomarker subcohort, the most frequent abnormalities were total cholesterol (60.0%), triglycerides (53.8%), UACR (45.5%), urea (40.0%), uric acid (40.0%), and ALT (35.3%). Elevated urea showed the largest female-to-male odds ratio (17.50, 95% CI 1.22–250.37; p = 0.041), but no sex–biomarker association remained significant after false-discovery-rate correction (minimum q = 0.295). Conclusions: The study demonstrates temporal heterogeneity in elevated-HbA1c record composition and a descriptive young-adult biomarker profile dominated by dyslipidemia, albuminuria, selected renal–metabolic abnormalities, and ALT elevation. Because the archived dataset did not retain the paired continuous HbA1c–biomarker data or older-age biomarker data needed for dose–response or cross-age comparisons, the findings should not be interpreted as establishing an HbA1c-linked multiorgan causal relationship. They support the value of integrated organ-risk assessment and the need for prospective patient-level analyses across HbA1c and age strata.