Study Examines Effects of HbA1c on CVD Risk

High hemoglobin glycation index (HGI) was independently associated with overall and individual cardiovascular disease (CVD) prevalence in individuals with impaired glucose metabolism, according to the findings of a recent study.

The cross-sectional analysis included 1248 individuals with prediabetes or diabetes who had not been treated. The main outcomes included prevalence of composite and individual CVD, including coronary artery disease (CAD), stroke, and peripheral artery disease (PAD). Researchers defined HGI by subtracting predicted HbA_1c (calculated from the linear relationship between HbA_1c and fasting plasma glucose levels) from measured HbA_1c, and grouped participants based on HGI.
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The prevalence of composite CVD was 10.3%, and individual prevalence for CAD was 5.7%, for stroke was 5.1%, and for PAD was 1.3%.

Individual CVD prevalence was found to increase significantly with increases in HGI.

After adjustments for other CVD risk factors, including HbA_1c levels, the researchers found that high HGI was independently associated with composite CVD, and individual CAD, stroke, and PAD. The odds ratios for those in the highest tertile of HGI was 2.81 for composite CVD, was 2.3 for CAD, was 3.4 for stroke, and was 6.37 for PAD.

“Two consecutive measurements of HGI obtained on different days showed good correlation (r = 0.651, P <0.001) and high concordance rate in the tertile classification (69.1%),” the researchers wrote.

“This result suggests that discrepancy between HbA_1c and fasting glucose levels can reflect vascular health in subjects with impaired glucose metabolism.”

—Melissa Weiss

Reference:

Chang HA, Min SH, Dong-Wha L, et al. Hemoglobin Glycation index is associated with cardiovascular disease in people with impaired glucose metabolism [published online May 23, 2017]. J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2017-00191.