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Association Between Coronary Artery Calcification and the Hemoglobin Glycation Index: The Kangbuk Samsung Health
Eun-Jung Rhee1, Jung-Hwan Cho1, Hyemi Kwon1
1Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Republic of Korea.
Insights
A high hemoglobin glycation index (HGI) correlates with increased cardiovascular risk. Consistently elevated HGI over time significantly raises the risk for coronary artery calcification (CAC) in non-diabetic individuals.
Area of Science:
- Cardiovascular disease research
- Metabolic health markers
- Biomarker analysis
Background:
- The hemoglobin glycation index (HGI) is associated with cardiovascular disease (CVD) risk.
- Understanding HGI's role in non-diabetic individuals is crucial for CVD prevention.
Purpose of the Study:
- To investigate the association between changes in HGI and incident coronary artery calcification (CAC) over 4 years.
- To analyze the predictive value of baseline and evolving HGI for CAC development in a non-diabetic population.
Main Methods:
- Retrospective analysis of 2052 non-diabetic participants with serial coronary artery calcium (CAC) scoring over 4 years.
- HGI calculated as the difference between measured and predicted Hemoglobin A1c (HbA1c).
- Statistical analysis adjusted for confounding variables to assess CAC incidence across HGI quartiles and changes.
Main Results:
- A higher baseline HGI was observed in participants who developed CAC.
- CAC incidence increased progressively with higher baseline HGI quartiles.
- An increasing HGI trend over 4 years significantly elevated CAC risk, independent of baseline HbA1c.
Conclusions:
- Elevated baseline and sustained high HGI are linked to increased risk of incident CAC.
- Changes in HGI over time are significant predictors of CAC development in non-diabetics.
- HGI monitoring may aid in stratifying cardiovascular risk in individuals without diabetes.
Context:
The hemoglobin glycation index (HGI) is known to be correlated with the risk for cardiovascular disease.
Objective:
To analyze the association between incident coronary artery calcification (CAC) and the changes in HGI among participants without diabetes, over 4 years.
Design, Setting, Participants, And Outcome Measures:
A retrospective study of 2052 nondiabetic participants in whom the coronary artery calcium score was measured repeatedly over 4 years, as part of a health checkup program in Kangbuk Samsung Hospital in Korea, and who had no CAC at baseline. The HGI was defined as the difference between the measured and predicted hemoglobin A1c (HbA1c) levels.
Results:
A total of 201 participants developed CAC after 4 years, and the mean baseline HGI was significantly higher in those patients. The incidence of CAC gradually increased from the first to the fourth quartile groups of baseline HGI. The odds ratio (OR) for incident CAC was the highest among the four groups divided by the quartiles of the baseline HGI and was significant after adjustment for confounding variables (vs first quartile group: OR, 1.632; 95% confidence interval, 1.024 to 2.601). The incidence of and risk for CAC development were significantly higher than in other groups compared with the low-to-low group after adjustment for confounding factors; however, when baseline HbA1c level was included in the model, only participants with a low-to-high HGI over 4 years showed a significantly increased OR for CAC development compared with the low-to-low group (OR, 1.722; 95% confidence interval, 1.046 to 2.833).
Conclusions:
The participants with a high baseline HGI and consistently high HGI showed a higher risk for incident CAC than those with a low baseline HGI. An increased HGI over 4 years significantly increased the risk for CAC regardless of the baseline HbA1c levels.