State Key Laboratory of Cardiovascular Disease, Beijing, China.
Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Nutr Diabetes. 2024 Aug 28;14(1):69. doi: 10.1038/s41387-024-00318-x.
BACKGROUND/OBJECTIVES: The hemoglobin glycation index (HGI) has been demonstrated to serve as a substitute for the individual bias in glycosylated hemoglobin A1c (HbA1c). Our objective was to assess the correlation between HGI and cardiovascular (CV) outcomes in patients with diabetes and coronary artery disease (CAD).
SUBJECTS/METHODS: We sequentially recruited 11921 patients with diabetes and CAD at Fuwai Hospital. The patients were categorized into five groups based on their HGI quintiles, ranging from Q1 to Q5. The primary endpoint was the occurrence of major adverse cardiac events (MACEs), which included CV death and nonfatal myocardial infarction.
During the median 3-year follow-up, 327 (2.7%) MACEs were observed. A U-shaped relationship between HGI and 3-year MACEs was demonstrated by restricted cubic spline (RCS) after multivariable adjustment (nonlinear P = 0.014). The Kaplan-Meier curves demonstrated that the Q2 group had the lowest risk of MACE (P = 0.006). When comparing the HGI Q2 group, multivariable Cox regression models showed that both low (Q1) and high (Q4 or Q5) HGI were linked to a higher risk of MACEs (all P < 0.05). Patients with a low HGI (Q1) had a significantly increased risk of all-cause and CV death, with a 1.70-fold increase in both cases (both P < 0.05).
In individuals with diabetes and established CAD, HGI levels were found to have a U-shaped relationship with the occurrence of MACEs over a period of three years. Significantly, those with low HGI had an increased risk of CV death.
背景/目的：血红蛋白糖化指数（HGI）已被证明可替代糖化血红蛋白 A1c（HbA1c）的个体偏差。我们的目的是评估 HGI 与糖尿病和冠心病（CAD）患者心血管（CV）结局之间的相关性。
受试者/方法：我们连续招募了阜外医院的 11921 名糖尿病合并 CAD 患者。患者根据 HGI 五分位数分为五组，范围从 Q1 到 Q5。主要终点是主要不良心脏事件（MACE）的发生，包括 CV 死亡和非致死性心肌梗死。
在中位 3 年的随访期间，观察到 327 例（2.7%）MACE。多变量调整后受限立方样条（RCS）显示 HGI 与 3 年 MACE 之间呈 U 形关系（非线性 P=0.014）。Kaplan-Meier 曲线表明，Q2 组的 MACE 风险最低（P=0.006）。在比较 HGI Q2 组时，多变量 Cox 回归模型表明，低（Q1）和高（Q4 或 Q5）HGI 均与 MACE 风险增加相关（均 P<0.05）。HGI 较低（Q1）的患者全因和 CV 死亡风险显著增加，两种情况下的风险均增加了 1.70 倍（均 P<0.05）。
在患有糖尿病和已确诊 CAD 的患者中，HGI 水平与三年内发生 MACE 的情况呈 U 形关系。重要的是，HGI 较低的患者 CV 死亡风险增加。
