New Study Flags Hemoglobin Glycation Index as Key Indicator of Cardiovascular Risk in Diabetes Patients
China: A new population-based cohort study has found a significant U-shaped relationship between the hemoglobin glycation index (HGI) and the risk of cardiovascular disease (CVD), including heart attack and congestive heart failure (CHF), among individuals with diabetes or prediabetes. The research, published in Diabetology & Metabolic Syndrome, was led by Zheng Wang and colleagues from the Department of Cardiology at the Second People’s Hospital of Hefei, affiliated with Anhui Medical University, China.
Using data from 10,889 participants enrolled in the U.S. National Health and Nutrition Examination Survey (NHANES), the study assessed how variations in HGI could predict cardiovascular events. The average age of participants was approximately 53 years, and more than half were male. The researchers employed weighted multivariable regression models, restricted cubic splines, and subgroup analyses to examine the nonlinear relationship between baseline HGI and cardiovascular outcomes.
The analysis led to the following findings:
- The analysis showed a U-shaped association between hemoglobin glycation index (HGI) and cardiovascular risk, indicating that both low and high HGI levels were linked to increased heart-related complications.
- Inflection points were identified at -0.140 for cardiovascular disease (CVD) and congestive heart failure (CHF), and -0.447 for heart attack.
- Beyond these thresholds, each unit increase in HGI was associated with a 34% rise in the risk of CVD and heart attack and a 39% increase in CHF risk.
- Individuals with either unusually low or high HGI values faced a higher likelihood of cardiovascular events.
- HGI reflects the difference between actual and predicted HbA1c levels, offering insight into individual variability in glucose-related hemoglobin changes.
- While HbA1c remains a key marker for long-term blood sugar control, HGI may provide supplementary value in identifying those at heightened cardiovascular risk.
- Subgroup analysis indicated racial differences in the association between HGI and heart failure risk, pointing to the role of ethnicity in cardiovascular risk profiling.
- The findings emphasize the need for individualized cardiovascular risk assessments in people with diabetes or prediabetes.
Although the study sheds light on a novel potential biomarker, the researchers caution that these findings are exploratory in nature. They call for further large-scale studies to confirm HGI’s predictive value and establish its clinical applicability in cardiovascular risk stratification.
"The study highlights the potential utility of the hemoglobin glycation index as an early indicator of cardiovascular risk among individuals with diabetes or prediabetes. Monitoring HGI alongside traditional markers could enhance efforts to prevent heart disease in this high-risk population," the authors concluded.
Reference:
Wang, Z., Shi, F., Wang, L. et al. The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study. Diabetol Metab Syndr 17, 171 (2025). https://doi.org/10.1186/s13098-025-01754-0
