Hemoglobin Glycation Index valuable Biomarker for Frailty and Mortality in Hypertension: Study
According to a new study Hemoglobin Glycation Index (HGI) is a valuable biomarker in hypertensive patients: higher HGI levels are linked to increased frailty risk, and its U-shaped association with all-cause mortality underscores its importance for risk stratification. The study was published in BMC Diabetology & Metabolic Syndrome by Zebin Lin and colleagues.
In the study, 1773 hypertensive participants from the CHARLS database were analyzed. HGI was calculated by the following formula: HGI = measured HbA1c – predicted HbA1c. Frailty and mortality associations were examined by multivariable logistic regression, Cox proportional hazards regression, mediation analysis, and threshold effect detection. The investigators specifically assessed whether diabetes acted as a mediator and explored possible inflection points in the HGI–mortality curve for non-linear patterns.
Results
HGI was independently associated with frailty, with an adjusted OR of 1.28 (95% CI: 1.03–1.60).
Mediation analysis showed that diabetes accounted for 27.8% of the link between increasing HGI and the risk of frailty, supporting the hypothesis that hyperglycemia is a major factor in the functional decline of hypertensive patients.
The researchers found a U-shaped relationship for mortality, with an inflection point at HGI = –0.15.
Among the overall hypertensive sample, in those with HGI ≥ –0.15, the association of HGI with mortality was not statistically significant (adjusted HR 1.17; 95% CI: 0.92–1.50).
Among frail patients in this same HGI range, however, every 1-unit increase in HGI was associated with a 60% increased risk of mortality (HR 1.60; 95% CI: 1.11–2.32).
When HGI was less than –0.15, higher HGI values were related to lower mortality in the general hypertensive population, with an adjusted HR of 0.68; 95% CI: 0.49–0.95.
A somewhat similar protective trend seems to have appeared in the frailty subgroup, where the adjusted HR was 0.36; 95% CI: 0.13–0.97.
This study showed that HGI is a meaningful biomarker of frailty and mortality in hypertensive patients. These findings indicate that HGI can be used to guide risk stratification and enhance clinical decision-making in managing hypertension.
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