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Limited benefit of haemoglobin glycation index as risk factor for cardiovascular disease in type 2 diabetes patients

H B Østergaard1, T Mandrup-Poulsen2, G F N Berkelmans3

  • 1Department of Vascular Medicine, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 22, 2200 Copenhagen N, Denmark.

Diabetes & Metabolism
|May 23, 2018
PubMed

Insights

Higher haemoglobin glycation index (HGI) increases cardiovascular disease (CVD) risk in type 2 diabetes patients without prior CVD. HGI offers limited additional clinical benefit over HbA1c due to complexity.

Area of Science:

  • Endocrinology
  • Cardiology
  • Metabolic Syndrome

Background:

  • The haemoglobin glycation index (HGI) reflects interindividual differences in haemoglobin glycosylation.
  • Previous research links high HGI to increased cardiovascular disease (CVD) risk in diabetic patients.
  • The impact of prior CVD on the HGI-CVD risk association remains unexamined.

Purpose of the Study:

  • To investigate the association between HGI and cardiovascular events in patients with type 2 diabetes mellitus (T2DM).
  • To determine if previous CVD influences the relationship between HGI and cardiovascular outcomes.

Main Methods:

  • Utilized data from 1910 T2DM patients in the Second Manifestations of Arterial Disease (SMART) study.
  • Employed Cox proportional-hazards models to assess HGI and HbA1c against composite cardiovascular events and mortality.
  • Conducted analyses stratified by the presence or absence of previous CVD.

Main Results:

  • A 1-unit increase in HGI correlated with a 29% higher risk of cardiovascular events in patients without prior CVD (HR: 1.29).
  • No significant association was observed between HGI and cardiovascular events in patients with previous CVD (HR: 0.96).
  • HGI and HbA1c demonstrated similar risk associations; HGI's clinical utility may be limited by complexity.

Conclusions:

  • Elevated HGI is associated with increased cardiovascular event risk in T2DM patients without a history of CVD.
  • The clinical benefit of HGI over HbA1c in risk prediction for T2DM patients appears limited.
  • HGI's complexity in measurement and interpretation may restrict its widespread clinical application.
Abstract

Keywords:
Cardiovascular diseaseDiabetes mellitus type 2Glycaemic controlHGIHaemoglobin glycation indexHbA(1c)

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