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High glycation index increases CVD risk
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Adults with prediabetes or diabetes have an increased risk for cardiovascular diseases when they have high hemoglobin glycation index, according to findings published in The Journal of Clinical Endocrinology & Metabolism.
Soo Lim, MD, MPH, PhD, associate professor in the department of internal medicine at Seoul National University College of Medicine and Seoul National University Bundang Hospital, and colleagues evaluated data from the Seoul National University Bundang Hospital oral glucose tolerance test registry on 1,248 adults (mean age, 55.3 years) with diabetes or prediabetes who were treatment-naive to determine the associations between interindividual variations in HbA1c, estimated as hemoglobin glycation index, and CVD. Measured HbA1c minus predicted HbA1c calculated from the linear relationship between HbA1c and fasting plasma glucose was used to define hemoglobin glycation index.
The prevalence of CVD was 10.3%, individual coronary artery disease was 5.7%, stroke was 5.1% and peripheral artery disease was 1.3%; CVD prevalence increased with increasing hemoglobin glycation index tertiles. Composite CVD in the multivariate analysis, adjusted for age, sex, BMI, smoking, hypertension, dyslipidemia, family history of CVD, HDL cholesterol, LDL cholesterol and high sensitivity C-reactive protein, was independently associated with the second (OR = 1.77; 95% CI, 1.02-3.09) and third tertiles (OR = 3.13; 95% CI, 1.83-5.34) compared with the first tertile.
After adjustment for CVD risk factors and HbA1c levels, a consistently high hemoglobin glycation index was significantly associated with composite CVD (OR = 2.8; 95% CI, 1.75-4.48), CAD (OR = 2.84; 95% CI, 1.57-5.15), stroke (OR = 2.12; 95% CI, 1.14-3.93) and peripheral artery disease (OR = 4.97; 95% CI, 1.44-17.19).
“We have demonstrated a significant association between high [hemoglobin glycation index] and macrovascular complications,” the researchers wrote. “This was independent of HbA1c levels as well as conventional [CV] risk factors. [Hemoglobin glycation index] is a simple derivative of FPG and HbA1c, and this simplicity is its strength of [hemoglobin glycation index] as a clinical index. However, we cannot determine whether [hemoglobin glycation index] is a dominant factor contributing to the development of CVD in people with impaired glucose metabolism. The clinical implications of HGI should be investigated prospectively.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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