Gao Dongmei, Wang Aiping
Department of Endocrinology, The First People's Hospital of Yuhang District, No.1260, Kangliang Street, Liangzhu Street, Hangzhou, 311100, Zhejiang, China.
Department of Emergency Medicine, Hospital of Traditional Chinese Medicine of Songyang, No. 5 Zhonglou Road, Songyang, Lishui, 323400, Zhejiang, China.
BMC Cardiovasc Disord. 2025 May 15;25(1):368. doi: 10.1186/s12872-025-04742-4.
The hemoglobin glycation index (HGI), which quantifies the difference between observed and predicted hemoglobin A1c (HbA1c) levels, has been linked to adverse outcomes. However, its relationship with myocardial infarction (MI) in patients with diabetes mellitus (DM) remains unexplored. This study aimed to investigate the association between HGI and MI incidence in critically ill patients with diabetes mellitus (DM) using data from the MIMIC-IV database.
Linear regression analysis of HbA1c and fasting blood glucose levels was conducted to calculate HGI. Subsequently, differences in MI incidence across HGI quartiles were assessed using the Kaplan-Meier survival analysis, with the log-rank test applied. Cox proportional hazards models and restricted cubic spline (RCS) analyses were conducted to estimate hazard ratios (HRs) for MI risk across HGI quartiles, with Q1 as the reference.
A total of 8,055 DM patients with an initial ICU admission exceeding 24 h were included, with 21.5% of them presenting MI. Compared to HGI Q1 (-3.81, -1.236), the risk of MI increased by 1.26 times in Q2 (HR: 1.26, 95% confidence interval [CI]: 1.10-1.45), 1.48 times in Q3 (HR: 1.48, 95% CI: 1.29-1.69), and 1.39 times in Q4 (HR: 1.39, 95% CI: 1.21-1.60). RCS analysis showed a nonlinear positive association between HGI and outcome events that remained consistent across different subgroups as the stratified analysis suggested.
A significant correlation was revealed between HGI and the risk of MI in patients with DM, especially among those with elevated HGI levels, suggesting that HGI may serve as a potential biomarker for assessing MI risk in this population.
血红蛋白糖化指数（HGI）用于量化观察到的和预测的糖化血红蛋白（HbA1c）水平之间的差异，它与不良结局相关。然而，其与糖尿病（DM）患者心肌梗死（MI）的关系仍未得到探索。本研究旨在利用多中心重症监护医学信息数据库（MIMIC-IV）的数据，调查危重症糖尿病患者中HGI与MI发生率之间的关联。
对HbA1c和空腹血糖水平进行线性回归分析以计算HGI。随后，使用Kaplan-Meier生存分析评估HGI四分位数间MI发生率的差异，并应用对数秩检验。进行Cox比例风险模型和受限立方样条（RCS）分析，以估计HGI四分位数间MI风险的风险比（HR），以第一四分位数（Q1）作为对照。
共纳入8055例首次入住重症监护病房（ICU）超过24小时的DM患者，其中21.5%发生MI。与HGI Q1（-3.81，-1.236）相比，MI风险在Q2增加了1.26倍（HR：1.26，95%置信区间[CI]：1.10-1.45），在Q3增加了1.48倍（HR：1.48，95%CI：1.29-1.69），在Q4增加了1.39倍（HR：1.39，95%CI：1.21-1.60）。RCS分析显示HGI与结局事件之间存在非线性正相关，分层分析表明这种相关性在不同亚组中保持一致。
研究揭示了DM患者中HGI与MI风险之间存在显著相关性，尤其是在HGI水平升高的患者中，这表明HGI可能作为评估该人群MI风险的潜在生物标志物。
