Cefalo Chiara M A, Rubino Mariangela, Fiorentino Teresa Vanessa, Cassano Velia, Mannino Gaia Chiara, Riccio Alessia, Succurro Elena, Perticone Maria, Sciacqua Angela, Andreozzi Francesco, Sesti Giorgio
Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00189, Rome, Italy.
Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy.
Cardiovasc Diabetol. 2025 Apr 2;24(1):148. doi: 10.1186/s12933-025-02710-y.
The hemoglobin glycation index (HGI) has been linked to cardiovascular disease in diabetic patients. However, it remains unclear whether an elevated HGI similarly affects the cardiovascular system in individuals with normal glucose tolerance or prediabetes. In this cross-sectional study, we aimed to determine whether increased HGI levels are associated with a reduction in myocardial mechano-energetic efficiency (MEE), a key predictor of cardiovascular events and heart failure, in non-diabetic subjects.
Myocardial MEE per gram of left ventricular mass (MEEi) was assessed via echocardiography in a cohort of 1,074 adults with different glucose tolerance statuses, enrolled in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study. HGI was defined as the difference between the measured HbA1c and the predicted HbA1c, the latter calculated from the linear association between HbA1c and fasting plasma glucose levels.
Subjects in the highest HGI quartile exhibited significantly elevated myocardial oxygen consumption and a marked reduction in MEEi compared to those in the lowest quartile. A significant inverse correlation was observed between HGI and MEEi (r = - 0.210, P < 0.001). A multivariate linear regression analysis confirmed the strong relationship between higher HGI levels and lower MEEi, even after adjusting for several potential confounders, including sex, age, body mass index, waist circumference, smoking status, triglycerides, HDL cholesterol, 2-hour post-load glucose, glucose tolerance status, fasting insulin, HOMA-IR, hs-CRP, antihypertensive therapy, and lipid-lowering therapy.
These findings support the hypothesis that higher HGI values may affect myocardial mechano-energetic efficiency in non-diabetic individuals.
血红蛋白糖化指数（HGI）与糖尿病患者的心血管疾病有关。然而，尚不清楚升高的HGI是否同样会影响糖耐量正常或糖尿病前期个体的心血管系统。在这项横断面研究中，我们旨在确定HGI水平升高是否与非糖尿病受试者心肌机械能量效率（MEE）降低有关，MEE是心血管事件和心力衰竭的关键预测指标。
在参加卡坦扎罗代谢风险因素（CATAMERI）研究的1074名具有不同糖耐量状态的成年人队列中，通过超声心动图评估每克左心室质量的心肌MEE（MEEi）。HGI定义为测量的糖化血红蛋白（HbA1c）与预测的HbA1c之间的差值，后者根据HbA1c与空腹血糖水平之间的线性关联计算得出。
与最低四分位数的受试者相比，HGI最高四分位数的受试者心肌耗氧量显著升高，MEEi显著降低。观察到HGI与MEEi之间存在显著的负相关（r = -0.210，P < 0.001）。多变量线性回归分析证实，即使在调整了几个潜在的混杂因素后，包括性别、年龄、体重指数、腰围、吸烟状况、甘油三酯、高密度脂蛋白胆固醇、负荷后2小时血糖、糖耐量状态、空腹胰岛素、稳态模型评估的胰岛素抵抗（HOMA-IR）、高敏C反应蛋白（hs-CRP）、抗高血压治疗和降脂治疗，较高的HGI水平与较低的MEEi之间仍存在密切关系。
这些发现支持以下假设，即较高的HGI值可能会影响非糖尿病个体的心肌机械能量效率。
