Association between hemoglobin glycation index and 5-year major adverse cardiovascular events:the REACTION cohort study  

作　　者：Yuhan Wang Hongzhou Liu Xiaodong Hu Anping Wang Anning Wang Shaoyang Kang Lingjing Zhang Weijun Gu Jingtao Dou Yiming Mu Kang Chen Weiqing Wang Zhaohui Lyu 

机构地区：[1]Department of Endocrinology,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China [2]Department of Endocrinology,The Second Medical Center and National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China [3]Department of Endocrinology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai Institute of Endocrine and Metabolic Diseases,Shanghai 200025,China

出　　处：《Chinese Medical Journal》2023年第20期2468-2475,共8页中华医学杂志（英文版）

摘　　要：Background:The hemoglobin glycation index(HGI)was developed to quantify glucose metabolism and individual differences and proved to be a robust measure of individual glycosylated hemoglobin(HbA1c)bias.Here,we aimed to explore the relationship between different HGIs and the risk of 5-year major adverse cardiovascular events(MACEs)by performing a large multicenter cohort study in China.Methods:A total of 9791 subjects from the Risk Evaluation of Cancers in Chinese Diabetic Individuals:a Longitudinal Study(the REACTION study)were divided into five subgroups(Q1-Q5)with the HGI quantiles(≤5th,>5th and≤33.3th,>33.3th and≤66.7th,>66.7th and≤95th,and>95th percentile).A multivariate logistic regression model constructed by the restricted cubic spline method was used to evaluate the relationship between the HGI and the 5-year MACE risk.Subgroup analysis between the HGI and covariates were explored to detect differences among the five subgroups.Results:The total 5-year MACE rate in the nationwide cohort was 6.87%(673/9791).Restricted cubic spline analysis suggested a U-shaped correlation between the HGI values and MACE risk after adjustment for cardiovascular risk factors(x^(2)=29.5,P<0.001).After adjustment for potential confounders,subjects with HGIs≤-0.75 or>0.82 showed odds ratios(ORs)for MACE of 1.471(95%confidence interval[CI],1.027-2.069)and 2.222(95%CI,1.641-3.026)compared to subjects with HGIs of>-0.75 and≤-0.20.In the subgroup with non-coronary heart disease,the risk of MACE was significantly higher in subjects with HGIs≤-0.75(OR,1.540[1.039-2.234];P=0.027)and>0.82(OR,2.022[1.392-2.890];P<0.001)compared to those with HGIs of≤-0.75 or>0.82 after adjustment for potential confounders.Conclusions:We found a U-shaped correlation between the HGI values and the risk of 5-year MACE.Both low and high HGIs were associated with an increased risk of MACE.Therefore,the HGI may predict the 5-year MACE risk.

关 键 词：Diabetes mellitus Hemoglobin glycation index Major adverse cardiovascular events Blood glucose METABOLISM Ushaped correlation 

分 类 号：R54[医药卫生—心血管疾病]