Zhao Leiyong, Li Chengjun, Lv Hequn, Zeng Chunli, Peng Yongjun
Department of Acupuncture and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Department of Neurology, Huangdao District Hospital of Traditional Chinese Medicine, Qingdao, China.
Front Endocrinol (Lausanne). 2024 Nov 29;15:1447184. doi: 10.3389/fendo.2024.1447184. eCollection 2024.
Research on the association between blood glucose-related biomarkers and mortality has gained increasing attention. However, the association of hemoglobin glycation index (HGI) with all-cause and cardio-cerebrovascular mortality among people with metabolic syndrome has never been investigated. The objective of this study was to examine the association through a cohort study of the American population.
In this study, 8,267 participants were included. We utilized multivariable Cox regression analyses to explore the relationship between HGI and outcomes. The dose-response relationship between HGI and mortality was explored with restricted cubic splines. Recursive algorithms and segmented linear regression models were used to calculate the inflection points and assess the effect relationships before and after the inflection points.
In the model adjusting for all covariates, our analysis did not reveal a statistically significant association between HGI and mortality. Intriguingly, subsequent explorations of non-linear relationships unearthed a U-shaped correlation between HGI and both all-cause mortality and cardio-cerebrovascular mortality among American adults with metabolic syndrome. Before and after the inflection point, the HRs (95%CIs) for the association between HGI and all-cause mortality were 0.72 (0.63, 0.82) and 1.30 (1.17, 1.44), respectively. For cardio-cerebrovascular mortality, similar opposite relationships were found. The metabolic syndrome population with HGI levels at T2 had a lower rate of mortality.
This cohort study of the American metabolic syndrome population highlighted a U-shaped association of HGI with all-cause and cardio-cerebrovascular mortality.
关于血糖相关生物标志物与死亡率之间关联的研究日益受到关注。然而，糖化血红蛋白指数（HGI）与代谢综合征患者全因死亡率和心脑血管死亡率之间的关联从未被研究过。本研究的目的是通过对美国人群的队列研究来检验这种关联。
本研究纳入了8267名参与者。我们使用多变量Cox回归分析来探讨HGI与结局之间的关系。采用受限立方样条来探索HGI与死亡率之间的剂量反应关系。使用递归算法和分段线性回归模型来计算拐点，并评估拐点前后的效应关系。
在调整所有协变量的模型中，我们的分析未发现HGI与死亡率之间存在统计学上的显著关联。有趣的是，随后对非线性关系的探索发现，在美国患有代谢综合征的成年人中，HGI与全因死亡率和心脑血管死亡率之间呈U形关联。在拐点前后，HGI与全因死亡率之间关联的HR（95%CI）分别为0.72（0.63，0.82）和1.30（1.17，1.44）。对于心脑血管死亡率，也发现了类似的相反关系。HGI水平处于T2的代谢综合征人群死亡率较低。
这项针对美国代谢综合征人群的队列研究突出了HGI与全因死亡率和心脑血管死亡率之间的U形关联。
