- Diabetes, obesity and metabolism
- Importance of the Hemoglobin Glycation Index for Risk of Cardiovascular and Microvascular Complications and Mortality in Individuals with Type 2 Diabetes
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Claudia Regina Lopes Cardoso, Nathalie Carvalho Leite, Gil Fernando Salles
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Endocrinol Metab. 2024;39(5):732-747. Published online October 15, 2024
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DOI: https://doi.org/10.3803/EnM.2024.2001
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 Abstract
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- Background
This study investigated the prognostic importance of the hemoglobin glycation index (HGI) for macrovascular and microvascular outcomes, mortality, and hypoglycemia occurrence in a type 2 diabetes cohort and compared it to glycated hemoglobin (HbA1c).
Methods
Baseline and mean first-year HGI and HbA1c, and the variability thereof, were assessed in 687 individuals with type 2 diabetes (median follow-up, 10.6 years). Multivariable Cox regression was conducted to evaluate the associations of HGI and HbA1c parameters with macrovascular (total and major cardiovascular events) and microvascular outcomes (microalbuminuria, advanced renal failure, retinopathy, and peripheral neuropathy), mortality (all-cause and cardiovascular), and moderate/severe hypoglycemia occurrence.
Results
During follow-up, there were 215 total cardiovascular events (176 major) and 269 all-cause deaths (131 cardiovascular). Microalbuminuria developed in 126 patients, renal failure in 104, retinopathy in 161, and neuropathy in 177. There were 90 hypoglycemia episodes. Both HGI and HbA1c predicted all adverse outcomes, except microalbuminuria and hypoglycemia. Their adjusted risks were roughly equivalent for all outcomes. For example, the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), estimated for 1 standard deviation increments, of mean first-year HGI were 1.23 (1.05 to 1.44), 1.20 (1.03 to 1.38), 1.36 (1.11 to 1.67), 1.28 (1.09 to 1.67), and 1.29 (1.09 to 1.54), respectively, for cardiovascular events, all-cause mortality, renal failure, retinopathy, and neuropathy; whereas the respective HRs (95% CIs) of mean HbA1c were 1.31 (1.12 to 1.53), 1.28 (1.11 to 1.48), 1.36 (1.11 to 1.67), 1.33 (1.14 to 1.55), and 1.29 (1.09 to 1.53).
Conclusion
HGI was no better than HbA1c as a predictor of adverse outcomes in individuals with type 2 diabetes, and its clinical use cannot be currently advised.
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Citations
Citations to this article as recorded by  - Hemoglobin glycation index and rapid kidney function decline in diabetes patients: Insights from CHARLS
Fan Zhang, Rui Zhou, Yan Bai, Liuyan Huang, Jiao Li, Yifei Zhong
Diabetes Research and Clinical Practice.2025; 222: 112054. CrossRef - Association of hemoglobin glycation index and diabetic retinopathy results from NHANES
Ning Feng, Guang-Jie Cheng, Shun-Feng Zhao, Lin-Jun Du, Ning Guo, Na Zhang
International Journal of Diabetes in Developing Countries.2025;[Epub] CrossRef
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