Hemoglobin glycation index and cardiovascular outcomes in patients with diabetes and coronary artery disease: insights from a large cohort study.

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Nutrition & Diabetes Pub Date : 2024-08-28 DOI:10.1038/s41387-024-00318-x

Zhangyu Lin, Jining He, Sheng Yuan, Chenxi Song, Xiaohui Bian, Min Yang, Kefei Dou

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Abstract

Background/objectives: The hemoglobin glycation index (HGI) has been demonstrated to serve as a substitute for the individual bias in glycosylated hemoglobin A1c (HbA1c). Our objective was to assess the correlation between HGI and cardiovascular (CV) outcomes in patients with diabetes and coronary artery disease (CAD).

Subjects/methods: We sequentially recruited 11921 patients with diabetes and CAD at Fuwai Hospital. The patients were categorized into five groups based on their HGI quintiles, ranging from Q1 to Q5. The primary endpoint was the occurrence of major adverse cardiac events (MACEs), which included CV death and nonfatal myocardial infarction.

Results: During the median 3-year follow-up, 327 (2.7%) MACEs were observed. A U-shaped relationship between HGI and 3-year MACEs was demonstrated by restricted cubic spline (RCS) after multivariable adjustment (nonlinear P = 0.014). The Kaplan-Meier curves demonstrated that the Q2 group had the lowest risk of MACE (P = 0.006). When comparing the HGI Q2 group, multivariable Cox regression models showed that both low (Q1) and high (Q4 or Q5) HGI were linked to a higher risk of MACEs (all P < 0.05). Patients with a low HGI (Q1) had a significantly increased risk of all-cause and CV death, with a 1.70-fold increase in both cases (both P < 0.05).

Conclusions: In individuals with diabetes and established CAD, HGI levels were found to have a U-shaped relationship with the occurrence of MACEs over a period of three years. Significantly, those with low HGI had an increased risk of CV death.

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糖尿病和冠心病患者的血红蛋白糖化指数与心血管预后：一项大型队列研究的启示。

背景/目的：血红蛋白糖化指数（HGI）已被证明可替代糖化血红蛋白 A1c（HbA1c）的个体偏差。我们的目的是评估糖尿病合并冠状动脉疾病（CAD）患者的 HGI 与心血管（CV）预后之间的相关性：我们在阜外医院连续招募了 11921 名糖尿病合并 CAD 患者。根据患者的 HGI 五分位数（从 Q1 到 Q5）将其分为五组。主要终点是主要心脏不良事件（MACE）的发生率，包括冠心病死亡和非致命性心肌梗死：中位随访 3 年期间，共观察到 327 例（2.7%）MACE。经多变量调整后，受限立方样条曲线（RCS）显示 HGI 与 3 年 MACE 之间呈 U 型关系（非线性 P = 0.014）。Kaplan-Meier 曲线显示，Q2 组的 MACE 风险最低（P = 0.006）。在对 HGI Q2 组进行比较时，多变量 Cox 回归模型显示，低（Q1）和高（Q4 或 Q5）HGI 都与较高的 MACE 风险有关（均为 P 结论：HGI Q2 组的 MACE 风险最低（P = 0.006）：研究发现，在患有糖尿病并已确诊为 CAD 的患者中，HGI 水平与三年内 MACE 的发生率呈 U 型关系。值得注意的是，HGI水平低的患者发生冠心病死亡的风险更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition & Diabetes ENDOCRINOLOGY & METABOLISM-NUTRITION & DIETETICS

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Nutrition & Diabetes is a peer-reviewed, online, open access journal bringing to the fore outstanding research in the areas of nutrition and chronic disease, including diabetes, from the molecular to the population level.