Association between hemoglobin glycation index and 5-year major adverse cardiovascular events: the REACTION cohort study.
10.1097/CM9.0000000000002717
- Author:
Yuhan WANG
1
;
Hongzhou LIU
2
;
Xiaodong HU
1
;
Anping WANG
1
;
Anning WANG
1
;
Shaoyang KANG
1
;
Lingjing ZHANG
1
;
Weijun GU
1
;
Jingtao DOU
1
;
Yiming MU
1
;
Kang CHEN
1
;
Weiqing WANG
3
;
Zhaohui LYU
1
Author Information
1. Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
2. Department of Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing 100853, China.
3. Department of Endocrinology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai 200025, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Cohort Studies;
Longitudinal Studies;
Diabetes Mellitus, Type 2/diagnosis*;
Maillard Reaction;
Glycated Hemoglobin;
Cardiovascular Diseases
- From:
Chinese Medical Journal
2023;136(20):2468-2475
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: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.
METHODS: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.
RESULTS: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.
CONCLUSIONS: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.
