Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Department of Cardiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Diabetes Res Clin Pract. 2022 Aug;190:109990. doi: 10.1016/j.diabres.2022.109990. Epub 2022 Jul 9.
To investigate the association of hemoglobin glycation index (HGI) and glycation gap (GGap), reflecting mismatches between HbA1c and other measures of glycemia, with cardiovascular disease (CVD) in the general population.
5966 US adult (age ≥ 20 years) participants were included from the National Health and Nutrition Examination Survey (NHANES) (1999-2004). In this cross-sectional study, predicted HbA1c was calculated based on fasting plasma glucose (FPG) and glycated albumin (GA), respectively. Multivariable binary logistic regression analysis was performed to explore the association of HGI and GGap with CVD prevalence.
Compared to the lowest tertile, the ORs with 95% CIs for CVD across the tertiles were 1.41 (1.01, 1.96) and 0.87 (0.58, 1.31) for HGI (P for trend = 0.535) and 1.06 (0.77, 1.47) and 1.60 (1.18, 2.17) for GGap (P for trend = 0.002) in the fully-adjusted model. Besides, the discordantly high GGap/low HbA1c group was associated with higher CVD prevalence compared with the low GGap/high HbA1c group (OR = 1.50, 95% CI, 1.04-2.16, P = 0.030).
GGap derived from GA is associated with CVD independent of traditional risk factors, even HbA1c, in US general adults. Considering the potential limitations of HbA1c, the introduction of GGap is warranted.
探讨血红蛋白糖化指数（HGI）和糖化差值（GGap）与心血管疾病（CVD）的相关性，HGI 和 GGap 反映了 HbA1c 与其他血糖测量值之间的不匹配。
本横断面研究纳入了美国国家健康和营养调查（NHANES）（1999-2004 年）中的 5966 名成年（年龄≥20 岁）参与者。在这项研究中，分别根据空腹血糖（FPG）和糖化白蛋白（GA）预测 HbA1c。采用多变量二项逻辑回归分析探讨 HGI 和 GGap 与 CVD 患病率的关系。
与最低三分位相比，HGI 三分位的 CVD 患病比值比（OR）及其 95%置信区间（CI）分别为 1.41（1.01，1.96）和 0.87（0.58，1.31）（趋势 P 值=0.535）；GGap 的 OR 及其 95%CI 分别为 1.06（0.77，1.47）和 1.60（1.18，2.17）（趋势 P 值=0.002）。在完全调整模型中，GA 衍生的 GGap 与 HbA1c 不一致的高 GGap/低 HbA1c 组与低 GGap/高 HbA1c 组相比，CVD 患病率更高（OR=1.50，95%CI，1.04-2.16，P=0.030）。
在美国普通成年人中，GA 衍生的 GGap 与 CVD 相关，独立于传统危险因素，甚至 HbA1c。考虑到 HbA1c 的潜在局限性，引入 GGap 是有必要的。
