Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2023 Oct 20;136(20):2468-2475. doi: 10.1097/CM9.0000000000002717. Epub 2023 Jun 2.
The hemoglobin glycation index (HGI) was developed to quantify glucose metabolism and individual differences and proved to be a robust measure of individual glycosylated hemoglobin (HbA1c) bias. Here, we aimed to explore the relationship between different HGIs and the risk of 5-year major adverse cardiovascular events (MACEs) by performing a large multicenter cohort study in China.
A total of 9791 subjects from the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study (the REACTION study) were divided into five subgroups (Q1-Q5) with the HGI quantiles (≤5th, >5th and ≤33.3th, >33.3th and ≤66.7th, >66.7th and ≤95th, and >95th percentile). A multivariate logistic regression model constructed by the restricted cubic spline method was used to evaluate the relationship between the HGI and the 5-year MACE risk. Subgroup analysis between the HGI and covariates were explored to detect differences among the five subgroups.
The total 5-year MACE rate in the nationwide cohort was 6.87% (673/9791). Restricted cubic spline analysis suggested a U-shaped correlation between the HGI values and MACE risk after adjustment for cardiovascular risk factors ( χ2 = 29.5, P <0.001). After adjustment for potential confounders, subjects with HGIs ≤-0.75 or >0.82 showed odds ratios (ORs) for MACE of 1.471 (95% confidence interval [CI], 1.027-2.069) and 2.222 (95% CI, 1.641-3.026) compared to subjects with HGIs of >-0.75 and ≤-0.20. In the subgroup with non-coronary heart disease, the risk of MACE was significantly higher in subjects with HGIs ≤-0.75 (OR, 1.540 [1.039-2.234]; P = 0.027) and >0.82 (OR, 2.022 [1.392-2.890]; P <0.001) compared to those with HGIs of ≤-0.75 or >0.82 after adjustment for potential confounders.
We found a U-shaped correlation between the HGI values and the risk of 5-year MACE. Both low and high HGIs were associated with an increased risk of MACE. Therefore, the HGI may predict the 5-year MACE risk.
血红蛋白糖化指数（HGI）旨在量化葡萄糖代谢和个体差异，并已被证明是衡量个体糖化血红蛋白（HbA1c）偏差的有力指标。在这里，我们旨在通过在中国进行一项大型多中心队列研究，探索不同 HGI 与 5 年主要不良心血管事件（MACE）风险之间的关系。
共有来自中国糖尿病个体癌症风险评估：一项纵向研究（REACTION 研究）的 9791 名受试者被分为五个亚组（Q1-Q5），根据 HGI 分位数（≤5 分、>5 分和≤33.3 分、>33.3 分和≤66.7 分、>66.7 分和≤95 分和>95 百分位）。使用受限立方样条法构建的多变量逻辑回归模型来评估 HGI 与 5 年 MACE 风险之间的关系。对 HGI 和协变量之间的亚组分析进行了探索，以检测五个亚组之间的差异。
全国队列的总 5 年 MACE 发生率为 6.87%（673/9791）。经过心血管危险因素调整后，受限立方样条分析表明 HGI 值与 MACE 风险之间呈 U 形相关性（χ2=29.5，P<0.001）。在调整潜在混杂因素后，HGI 值≤-0.75 或>0.82 的受试者发生 MACE 的比值比（OR）为 1.471（95%置信区间[CI]，1.027-2.069）和 2.222（95% CI，1.641-3.026），与 HGI 值>-0.75 和≤-0.20 的受试者相比。在非冠心病亚组中，与 HGI 值≤-0.75 或>-0.75 相比，HGI 值≤-0.75（OR，1.540[1.039-2.234]；P=0.027）和>0.82（OR，2.022[1.392-2.890]；P<0.001）的受试者发生 MACE 的风险显著更高，经潜在混杂因素调整后。
我们发现 HGI 值与 5 年 MACE 风险之间呈 U 形相关性。低 HGI 和高 HGI 均与 MACE 风险增加相关。因此，HGI 可能预测 5 年 MACE 风险。
