Association between hemoglobin glycation index and myocardial infarction in critically ill patients with diabetes mellitus: a retrospective study based on MIMIC-IV.

IF 2 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

BMC Cardiovascular Disorders Pub Date : 2025-05-15 DOI:10.1186/s12872-025-04742-4

Dongmei Gao, Aiping Wang

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引用次数: 0

Abstract

Background: The hemoglobin glycation index (HGI), which quantifies the difference between observed and predicted hemoglobin A1c (HbA1c) levels, has been linked to adverse outcomes. However, its relationship with myocardial infarction (MI) in patients with diabetes mellitus (DM) remains unexplored. This study aimed to investigate the association between HGI and MI incidence in critically ill patients with diabetes mellitus (DM) using data from the MIMIC-IV database.

Methods: Linear regression analysis of HbA1c and fasting blood glucose levels was conducted to calculate HGI. Subsequently, differences in MI incidence across HGI quartiles were assessed using the Kaplan-Meier survival analysis, with the log-rank test applied. Cox proportional hazards models and restricted cubic spline (RCS) analyses were conducted to estimate hazard ratios (HRs) for MI risk across HGI quartiles, with Q1 as the reference.

Results: A total of 8,055 DM patients with an initial ICU admission exceeding 24 h were included, with 21.5% of them presenting MI. Compared to HGI Q1 (-3.81, -1.236), the risk of MI increased by 1.26 times in Q2 (HR: 1.26, 95% confidence interval [CI]: 1.10-1.45), 1.48 times in Q3 (HR: 1.48, 95% CI: 1.29-1.69), and 1.39 times in Q4 (HR: 1.39, 95% CI: 1.21-1.60). RCS analysis showed a nonlinear positive association between HGI and outcome events that remained consistent across different subgroups as the stratified analysis suggested.

Conclusion: A significant correlation was revealed between HGI and the risk of MI in patients with DM, especially among those with elevated HGI levels, suggesting that HGI may serve as a potential biomarker for assessing MI risk in this population.

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基于MIMIC-IV的糖尿病危重患者血红蛋白糖化指数与心肌梗死的相关性回顾性研究

背景：血红蛋白糖化指数（HGI）量化了观察到的与预测的血红蛋白A1c （HbA1c）水平之间的差异，与不良结局有关。然而，其与糖尿病（DM）患者心肌梗死（MI）的关系尚不清楚。本研究旨在利用MIMIC-IV数据库的数据，探讨重症糖尿病（DM）患者HGI与心肌梗死发生率之间的关系。方法：对HbA1c和空腹血糖水平进行线性回归分析，计算HGI。随后，使用Kaplan-Meier生存分析评估HGI四分位数间心肌梗死发生率的差异，并应用log-rank检验。采用Cox比例风险模型和限制性三次样条（RCS）分析来估计HGI四分位数中心肌梗死风险的风险比（hr），以Q1为参考。结果：共纳入8055例首次入住ICU超过24小时的DM患者，其中21.5%出现心肌梗死。与HGI Q1（-3.81, -1.236）相比，第二季度心肌梗死风险增加1.26倍（HR: 1.26, 95%可信区间[CI]: 1.10-1.45），第三季度增加1.48倍（HR: 1.48, 95% CI: 1.29-1.69），第四季度增加1.39倍（HR: 1.39, 95% CI: 1.21-1.60）。RCS分析显示HGI与结局事件之间存在非线性正相关，分层分析表明，这种正相关在不同亚组中保持一致。结论：HGI与糖尿病患者心肌梗死风险之间存在显著相关性，特别是在HGI水平升高的糖尿病患者中，这表明HGI可能作为评估该人群心肌梗死风险的潜在生物标志物。

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

BMC Cardiovascular Disorders CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.50

自引率

0.00%

发文量

480

审稿时长

1 months

期刊介绍： BMC Cardiovascular Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the heart and circulatory system, as well as related molecular and cell biology, genetics, pathophysiology, epidemiology, and controlled trials.