Hemoglobin glycation index among adults with type 1 diabetes:Association with double diabetes features  

作　　者：Xiao-Lin Ji Min Yin Chao Deng Li Fan Yu-Ting Xie Fan-Su Huang Yan Chen Xia Li 

机构地区：[1]National Clinical Research Center for Metabolic Diseases,Key Laboratory of Diabetes Immunology(Central South University),Ministry of Education,and Department of Metabolism and Endocrinology,The Second Xiangya Hospital of Central South University,Changsha 410011,Hunan Province,China [2]Department of Endocrinology,The First Affiliated Hospital,Southwest Hospital,Army Medical University,Chongqing 400038,China [3]Department of Nutrition,The Second Xiangya Hospital of Central South University,Changsha 410011,Hunan Province,China

出　　处：《World Journal of Diabetes》2025年第4期153-165,共13页世界糖尿病杂志(英文)

基　　金：Supported by the National Key R D Program of China,No.2022YFC2010102;Natural Science Foundation of Hunan Province,No.2021JC0003;National Natural Science Foundation of China,No.82070812;the Sinocare Diabetes Foundation,No.LYF2022039.

摘　　要：ACKGROUND The hemoglobin glycation index(HGI)represents the discrepancy between the glucose management indicator(GMI)based on mean blood glucose levels and laboratory values of glycated hemoglobin(HbA1c).The HGI is a promising indicator for identifying individuals with excessive glycosylation,facilitating personalized evaluation and prediction of diabetic complications.However,the factors influencing the HGI in patients with type 1 diabetes(T1D)remain unclear.Autoimmune destruction of pancreaticβcells is central in T1D pathogenesis,yet insulin resistance can also be a feature of patients with T1D and their coexistence is called“double diabetes”(DD).However,knowledge regarding the relationship between DD features and the HGI in T1D is limited.AIM To assess the association between the HGI and DD features in adults with T1D.METHODS A total of 83 patients with T1D were recruited for this cross-sectional study.Laboratory HbA1c and GMI from continuous glucose monitoring data were collected to calculate the HGI.DD features included a family history of type 2 diabetes,overweight/obesity/central adiposity,hypertension,atherogenic dyslipidemia,an abnormal percentage of body fat(PBF)and/or visceral fat area(VFA)and decreased estimated insulin sensitivity.Skin autofluorescence of advanced glycation end products(SAF-AGEs),diabetic complications,and DD features were assessed,and their association with the HGI was analyzed.RESULTS A discrepancy was observed between HbA1c and GMI among patients with T1D and DD.A higher HGI was associated with an increased number of SAF-AGEs and a higher prevalence of diabetic microangiopathy(P=0.030),particularly retinopathy(P=0.031).Patients with three or more DD features exhibited an eight-fold increased risk of having a high HGI,compared with those without DD features(adjusted odds ratio=8.12;95%confidence interval:1.52-43.47).Specifically,an elevated PBF and/or VFA and decreased estimated insulin sensitivity were associated with high HGI.Regression analysis identified estimated insulin

关 键 词：Type 1 diabetes Double diabetes Insulin resistance Hemoglobin glycation index Advanced glycation end products Diabetic complications 

分 类 号：R587.1[医药卫生—内分泌]