Hemoglobin Glycation Index Is Associated With Cardiovascular Diseases in People With Impaired Glucose Metabolism

Ahn, Chang Ho; Min, Se Hee; Lee, Dong Hwa; Oh, Tae Jung; Kim, Kyoung Min; Moon, Jae Hoon; Choi, Sung Hee; Park, Kyong Soo; Jang, Hak Chul; Ha, Joon; Sherman, Arthur; Lim, Soo

doi:10.1210/jc.2017-00191

Cited by 61 publications

(58 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was beyond the scope of our study to attempt to identify the frequency of mismatches in the population, although our design led to one‐third of our participants having a high HGI mismatch and one‐third with a low HGI mismatch, sufficient to lead to false‐positive and false‐negative diagnoses, respectively; additional studies should pursue this objective. Finally, although our mismatch metric, HGI, is established in the literature , it is glycaemia‐dependent . We attempted to compensate for this by using separate regressions for each OGTT group, and it may be necessary to use HGI when the number of glucose samples is limited; future studies are also needed to examine the impact of mismatches with a glycaemia‐independent metric such as CGM‐based estimation of mean red blood cell age .…”

Section: Discussionmentioning

confidence: 99%

Impact of mismatches in HbA_1c vs glucose values on the diagnostic classification of diabetes and prediabetes

et al. 2019

View full text Add to dashboard Cite

Aims To determine whether HbA1c mismatches (HbA1c levels that are higher or lower than expected for the average glucose levels in different individuals) could lead to errors if diagnostic classification is based only on HbA1c levels. Methods In a cross‐sectional study, 3106 participants without known diabetes underwent a 75‐g oral glucose tolerance test (fasting glucose and 2‐h glucose) and a 50‐g glucose challenge test (1‐h glucose) on separate days. They were classified by oral glucose tolerance test results as having: normal glucose metabolism; prediabetes; or diabetes. Predicted HbA1c was determined from the linear regression modelling the relationship between observed HbA1c and average glucose (mean of fasting glucose and 2‐h glucose from the oral glucose tolerance test, and 1‐h glucose from the glucose challenge test) within oral glucose tolerance test groups. The haemoglobin glycation index was calculated as [observed – predicted HbA1c], and divided into low, intermediate and high haemoglobin glycation index mismatch tertiles. Results Those participants with higher mismatches were more likely to be black, to be men, to be older, and to have higher BMI (all P<0.001). Using oral glucose tolerance test criteria, the distribution of normal glucose metabolism, prediabetes and diabetes was similar across mismatch tertiles; however, using HbA1c criteria, the participants with low mismatches were classified as 97% normal glucose metabolism, 3% prediabetes and 0% diabetes, i.e. mostly normal, while those with high mismatches were classified as 13% normal glucose metabolism, 77% prediabetes and 10% diabetes, i.e. mostly abnormal (P<0.001). Conclusions Measuring only HbA1c could lead to under‐diagnosis in people with low mismatches and over‐diagnosis in those with high mismatches. Additional oral glucose tolerance tests and/or fasting glucose testing to complement HbA1c in diagnostic classification should be performed in most individuals.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of mismatches in HbA_1c vs glucose values on the diagnostic classification of diabetes and prediabetes

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The HGI reflects the difference between measured HbA1c and predicted HbA1c, which is calculated from mean blood glucose levels using a linear regression equation. Some studies suggest that higher HGI levels are associated with diabetic complications, metabolic disease and cardiovascular disease …”

Section: Introductionmentioning

confidence: 99%

“…associated with diabetic complications, metabolic disease and cardiovascular disease. [3][4][5][6][7][8][9] Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent metabolic diseases worldwide. 10 It can progress to steatohepatitis, cirrhosis and even hepatocellular carcinoma, which is associated with high mortality rates.…”

mentioning

confidence: 99%

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Yoo

Kang

Cho

et al. 2019

Clinical Endocrinology

View full text Add to dashboard Cite

Objectives The hemoglobin glycation index (HGI) quantifies interindividual variations in glycated hemoglobin (HbA1c) and is associated with diabetic complications and metabolic diseases. However, information on the association between HGI and non‐alcoholic fatty liver disease (NAFLD) in healthy subjects is limited, particularly in Asian populations. This study aimed to investigate the association between HGI and NAFLD in a healthy Korean cohort. Design Subjects were stratified in quartiles according to their HGI level. NAFLD was diagnosed by hepatic ultrasonography, hepatic steatosis index and fatty liver index. Multiple logistic regression analysis was performed to evaluate the association between HGI quartiles and the risk of NAFLD. Patients Data from subjects without diabetes who underwent liver ultrasonography during routine health examinations were retrospectively reviewed. Results Data from 14 465 subjects were included in the analysis. The prevalence of NAFLD increased significantly with each HGI quartile (24.8%, 29.7%, 32.6% and 40.6% in quartiles 1‐4, respectively; P < 0.001). In comparison with the lowest HGI quartile group, the highest quartile exhibited worse metabolic parameters, including body weight, waist circumference, body mass index and lipid profiles. Multiple logistic regression analysis adjusted for multiple factors showed that the odds ratio of having NAFLD was 1.564 (95% CI: 1.350‐1.813, P < 0.001) in the highest HGI quartile. Conclusions Elevated HGI levels are independently associated with NAFLD in a healthy Asian population.

show abstract

“…Recently, several studies have been performed to analyze the practical applicability of HGI measurements. A cross-sectional study demonstrated that high HGI levels signi cantly increased the risk of coronary artery disease, stroke, and peripheral artery disease in individuals with an impaired glucose metabolism [45]. The Kangbuk Samsung Health Study in Korean indicated that individuals with the highest HGI levels had a 1.722-fold risk of incident coronary artery calcium compared to the bottom group regardless of HbA1c levels [46].…”

Section: Discussionmentioning

confidence: 99%

Association of hemoglobin glycation index and its interaction with obesity /family history of hypertension on hypertension risk: a community-based cross-sectional survey

Song

Zhao

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: Hemoglobin glycation index (HGI) is considered to be a convenient measurable indicator to assess the inter-individual variation of HbA1c. In the present study, we tested the relationship between HGI and risk of hypertension, and further explored the possible interacting influences of HGI with other such factors on hypertension risk among Chinese individuals.Methods : The eligible subjects were chosen from a community-based cross-sectional survey in China. We collected relevant data and clinical indicators for each participant. HGI was calculated as “measured HbA1c-predicted HbA1c” and divided into four categories according to quartile. The following indicators were used to assess interactive effects：(1) relative excess risk due to interaction (RERI); (2) attributable proportion due to interaction (AP); and (3) synergy index (SI). Statistical analysis was performed using R software.Results: Specifically, 1777 eligible participants were selected in this cross-sectional survey. There were 433 subjects who were identified to have hypertension (24.4%). A significant increase in the prevalence of hypertension from Q1 to Q4 of HGI was observed (P<0.001). Multivariable logistic model demonstrated that subjects at the highest HGI group had a substantially increased risk of being hypertensive than subjects in the first quartile of HGI, as indicated by the OR value of 1.87(95%CI: 1.26-2.78). Moreover, a significant interaction between family history of hypertension and HGI on hypertension risk was detected (RERI:1.36,95%CI:0.11-2.63; AP: 0.43, 95%CI:0.17-0.69; and SI:2.68, 95% CI:1.10-6.48). The interactive effect between HGI and abdominal obesity was also found to be significant, as estimated by the value of RERI (1.04, 95%CI:0.24-1.85), AP (0.33, 95% CI: 0.11-0.56) and SI (1.96, 95%CI:1.01-3.79). However, in the analysis of the interaction between HGI and general obesity, only the AP value (0.28, 95%CI: 0.01-0.54) was observed to be significant.Conclusion: High HGI was independently associated with the risk of hypertension. Moreover, HGI significantly shared interactions with obesity and family history of hypertension that influenced the risk of hypertension.

show abstract

Hemoglobin Glycation Index Is Associated With Cardiovascular Diseases in People With Impaired Glucose Metabolism

Abstract: High HGI was independently associated with overall and individual CVDs. This result suggests that discrepancy between HbA1c and fasting glucose levels can reflect vascular health in subjects with impaired glucose metabolism.

Cited by 61 publications

References 41 publications

Impact of mismatches in HbA_1c vs glucose values on the diagnostic classification of diabetes and prediabetes

Impact of mismatches in HbA_1c vs glucose values on the diagnostic classification of diabetes and prediabetes

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Association of hemoglobin glycation index and its interaction with obesity /family history of hypertension on hypertension risk: a community-based cross-sectional survey

Contact Info

Product

Resources

About

Hemoglobin Glycation Index Is Associated With Cardiovascular Diseases in People With Impaired Glucose Metabolism

Abstract: High HGI was independently associated with overall and individual CVDs. This result suggests that discrepancy between HbA1c and fasting glucose levels can reflect vascular health in subjects with impaired glucose metabolism.

Cited by 61 publications

References 41 publications

Impact of mismatches in HbA1c vs glucose values on the diagnostic classification of diabetes and prediabetes

Impact of mismatches in HbA1c vs glucose values on the diagnostic classification of diabetes and prediabetes

The haemoglobin glycation index is associated with nonalcoholic fatty liver disease in healthy subjects

Association of hemoglobin glycation index and its interaction with obesity /family history of hypertension on hypertension risk: a community-based cross-sectional survey

Contact Info

Product

Resources

About

Impact of mismatches in HbA_1c vs glucose values on the diagnostic classification of diabetes and prediabetes

Impact of mismatches in HbA_1c vs glucose values on the diagnostic classification of diabetes and prediabetes