Department of Medical and Surgical Sciences, Viale Europa, University Magna-Græcia of Catanzaro, 88100 Catanzaro, Italy.
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
Diabetes Res Clin Pract. 2017 Dec;134:53-61. doi: 10.1016/j.diabres.2017.09.017. Epub 2017 Oct 6.
Hemoglobin glycation index (HGI), which is the difference between the observed value of HbA1 and the predicted HbA1c based on plasma glucose levels, represents a measure of the degree of non-enzymatic glycation of hemoglobin and it has been found to be positively associated with diabetic complications. Herein we investigated whether HGI is associated with hepatic steatosis and related biomarkers in subjects without diabetes.
1120 White individuals without diabetes were stratified in quartiles according to HGI levels. Hepatic steatosis was diagnosed by ultrasonography.
As compared with subjects in the lowest quartile of HGI those in the intermediate and high HGI groups displayed an unfavorable cardio-metabolic risk profile having significantly higher values of body mass index (BMI), waist circumference, % fat mass, total cholesterol, triglycerides, inflammatory markers such as high sensitivity C reactive protein, erythrocytes sedimentation rate, complement C3, platelets and white blood cell count, hepatic insulin resistance assessed by the liver IR index and lower concentrations of high-density lipoprotein. HGI was positively associated with the biomarker of liver damage alanine aminotransferase, and fatty liver index, an indicator of hepatic steatosis. In a logistic regression analysis adjusted for age, gender and BMI individuals in the highest quartile of HGI exhibited a 1.6-fold increased odd of having hepatic steatosis (95% CI: 1.03-2.41; p=0.03) as compared with subjects in the lowest quartile of HGI.
Higher levels of HGI may identify subjects without diabetes at increased risk of having hepatic steatosis.
血红蛋白糖基化指数(HGI)是基于血浆葡萄糖水平预测的 HbA1c 值与实际测量的 HbA1 之间的差值,它反映了血红蛋白非酶糖化的程度,并且已经发现与糖尿病并发症呈正相关。在此,我们研究了 HGI 是否与无糖尿病患者的肝脂肪变性和相关生物标志物有关。
根据 HGI 水平,将 1120 名无糖尿病的白人个体分为四组。通过超声检查诊断肝脂肪变性。
与 HGI 最低四分位数的个体相比,中高分位数 HGI 组的个体具有不利的心血管代谢风险特征,体重指数(BMI)、腰围、体脂百分比、总胆固醇、甘油三酯、炎症标志物(如高敏 C 反应蛋白、红细胞沉降率、补体 C3、血小板和白细胞计数)更高,肝脏胰岛素抵抗的评估指标(肝脏 IR 指数)和高密度脂蛋白浓度更低。HGI 与肝损伤标志物丙氨酸氨基转移酶和脂肪肝指数呈正相关,后者是肝脂肪变性的一个指标。在调整年龄、性别和 BMI 的逻辑回归分析中,HGI 最高四分位数的个体患肝脂肪变性的几率是 HGI 最低四分位数的个体的 1.6 倍(95%CI:1.03-2.41;p=0.03)。
较高的 HGI 水平可能表明无糖尿病个体患肝脂肪变性的风险增加。