Type 2 diabetes: haemoglobin glycation index offers limited benefit as risk factor for cardiovascular disease

  • Østergaard HB & al.
  • Diabetes Metab
  • 1 Jun 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with type 2 diabetes mellitus (T2DM) and without cardiovascular disease (CVD), higher haemoglobin glycation index (HGI) was associated with a higher risk for cardiovascular (CV) events whereas in those with T2DM and CVD, myocardial infarction (MI) risk was lower with higher HGI.
  • As glycated haemoglobin (HbA1c) confers similar risk and given the strong correlation between both HGI and HbA1c, additional benefit of using HGI as a risk factor for CV events is most likely limited.

Why this matters

  • HGI has been proposed as a marker of inter-individual differences in haemoglobin glycosylation.
  • Previous studies have demonstrated an association between high HGI and CVD risk in patients with diabetes. However, no studies have investigated the role of previous CVD in this association

Study design

  • This study included 1910 patients with T2DM, who participated in the Second Manifestations of Arterial Disease (SMART) study.
  • Primary outcomes: major adverse cardiovascular events (MACEs; MI, stroke, retinal infarction, and terminal heart failure).
  • Secondary outcomes: total mortality, CV mortality, MI and stroke.
  • Funding: None disclosed.

Key results

  • After adjustment for confounders, higher HGI was associated with increased risk for MACEs in patients without CVD (HR, 1.29; 95% CI, 1.06-1.57; P<.05 but not in those with previous cvd ci>
  • Similarly, higher HbA1c was associated with increased risk for MACEs in patients without CVD (HR, 1.23; 95% CI, 1.04-1.45; P<.05 but not in those with previous cvd ci>
  • No association observed between HGI, HbA1c and total mortality, CV mortality, MI and stroke.

Limitations

  • The predicted HbA1c was based on the only one fasting plasma glucose measurement.

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