Medical School of Chinese PLA, Beijing 100853, China; Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Diabetes Res Clin Pract. 2021 Oct;180:109039. doi: 10.1016/j.diabres.2021.109039. Epub 2021 Sep 3.
This study aimed to assess the effects of the hemoglobin glycation index (HGI) on hyperglycemia diagnosis and summarize the general characteristics of patients with a high-HGI phenotype.
The fasting plasma glucose and glycated hemoglobin (HbA1c) levels of participants (n = 47,648) were used to estimate a linear regression equation and determine the baseline HGI. Overall, 42,317 participants without a history of diabetes were included in the final analysis. The participants were divided into three groups according to the tertiles (low, moderate, and high) of baseline HGI. Proportions and variables were compared among the three HGI groups. A multivariate ordered logistic regression model was used to explore associations between related variables and the high-HGI phenotype.
Regression analysis indicated that the high-HGI phenotype was positively associated with female sex, advanced age, obesity, increased low-density lipoprotein and triglyceride levels, decreased high-density lipoprotein cholesterol, and postprandial glycemic excursion levels (all P < 0.05). The prevalence of hyperglycemia increased from the low- to the high-HGI groups when using HbA1c for diagnosis.
Individuals with high HGI have similar clinical characteristics. Measuring HbA1c alone for diagnosis could lead to inappropriate diabetes management decisions in people with low or high HGI.
本研究旨在评估血红蛋白糖化指数（HGI）对高血糖诊断的影响，并总结高 HGI 表型患者的一般特征。
利用参与者（n=47648）的空腹血糖和糖化血红蛋白（HbA1c）水平来估计线性回归方程，并确定基线 HGI。共有 42317 名无糖尿病病史的参与者被纳入最终分析。根据基线 HGI 的三分位（低、中、高）将参与者分为三组。比较三组 HGI 之间的比例和变量。采用多元有序逻辑回归模型探讨相关变量与高 HGI 表型之间的关系。
回归分析表明，高 HGI 表型与女性、高龄、肥胖、低密度脂蛋白和甘油三酯水平升高、高密度脂蛋白胆固醇降低以及餐后血糖波动水平升高呈正相关（均 P<0.05）。使用 HbA1c 进行诊断时，高 HGI 组的高血糖患病率从低 HGI 组逐渐升高。
HGI 较高的个体具有相似的临床特征。仅使用 HbA1c 进行诊断可能导致低或高 HGI 人群的糖尿病管理决策不当。
