The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study

Abstract Objective The relationship between Glycated Hemoglobin Index (HGI) and cardiovascular disease (CVD) risk in individuals with diabetes or prediabetes remains unclear. Therefore, this study aims to investigate the relationship between baseline HGI and CVD risk in U.S. adults with diabetes or...

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Main Authors: Zheng Wang, Fachao Shi, Long Wang, Caoyang Fang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01754-0
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author Zheng Wang
Fachao Shi
Long Wang
Caoyang Fang
author_facet Zheng Wang
Fachao Shi
Long Wang
Caoyang Fang
author_sort Zheng Wang
collection DOAJ
description Abstract Objective The relationship between Glycated Hemoglobin Index (HGI) and cardiovascular disease (CVD) risk in individuals with diabetes or prediabetes remains unclear. Therefore, this study aims to investigate the relationship between baseline HGI and CVD risk in U.S. adults with diabetes or prediabetes. Methods This study analyzed data from 10,889 diabetic or prediabetic participants from the National Health and Nutrition Examination Survey (NHANES). Weighted multivariable regression analysis and subgroup analyses were employed to assess the relationship between HGI and CVD risk. Restricted cubic splines were used to explore nonlinear associations, along with threshold effect analysis and subgroup analyses. Results A total of 10,889 participants (mean age 52.82 years, 54.57% male) were included in this study. We observed a U-shaped relationship between HGI and the risk of cardiovascular disease (CVD) (P nonlinear < 0.0001), heart attack (P nonlinear = 0.0006), and congestive heart failure (CHF) (P nonlinear = 0.0001). The inflection points for HGI concerning CVD, heart attack, and CHF were − 0.140, -0.447, and − 0.140, respectively. When baseline HGI exceeded these thresholds, each unit increase in HGI was significantly associated with higher risks of CVD (OR: 1.34, 95% CI: 1.23–1.48), heart attack(OR: 1.34, 95% CI: 1.20–1.51), and CHF (OR: 1.39, 95% CI: 1.22–1.58).Subgroup analysis revealed significant differences in CHF risk associated with HGI across racial groups (interaction P = 0.03). Conclusion In individuals with diabetes and prediabetes, HGI displays a U-shaped relationship with CVD, heart attack, and CHF risks, with threshold values of -0.14, -0.45, and − 0.14, respectively. HGI may serve as a more effective indicator for identifying populations at early risk for cardiovascular disease.
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spelling doaj-art-06a9e43fcb584396ac40c549f2c185252025-08-20T01:59:56ZengBMCDiabetology & Metabolic Syndrome1758-59962025-05-0117111710.1186/s13098-025-01754-0The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort studyZheng Wang0Fachao Shi1Long Wang2Caoyang Fang3Department of Cardiology, The Second People’s Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical UniversityDepartment of Cardiology, Maanshan People’s HospitalDepartment of Cardiology, The Second People’s Hospital of Hefei, Hefei Hospital, Affiliated to Anhui Medical UniversityDepartment of Emergency, First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial HospitalAbstract Objective The relationship between Glycated Hemoglobin Index (HGI) and cardiovascular disease (CVD) risk in individuals with diabetes or prediabetes remains unclear. Therefore, this study aims to investigate the relationship between baseline HGI and CVD risk in U.S. adults with diabetes or prediabetes. Methods This study analyzed data from 10,889 diabetic or prediabetic participants from the National Health and Nutrition Examination Survey (NHANES). Weighted multivariable regression analysis and subgroup analyses were employed to assess the relationship between HGI and CVD risk. Restricted cubic splines were used to explore nonlinear associations, along with threshold effect analysis and subgroup analyses. Results A total of 10,889 participants (mean age 52.82 years, 54.57% male) were included in this study. We observed a U-shaped relationship between HGI and the risk of cardiovascular disease (CVD) (P nonlinear < 0.0001), heart attack (P nonlinear = 0.0006), and congestive heart failure (CHF) (P nonlinear = 0.0001). The inflection points for HGI concerning CVD, heart attack, and CHF were − 0.140, -0.447, and − 0.140, respectively. When baseline HGI exceeded these thresholds, each unit increase in HGI was significantly associated with higher risks of CVD (OR: 1.34, 95% CI: 1.23–1.48), heart attack(OR: 1.34, 95% CI: 1.20–1.51), and CHF (OR: 1.39, 95% CI: 1.22–1.58).Subgroup analysis revealed significant differences in CHF risk associated with HGI across racial groups (interaction P = 0.03). Conclusion In individuals with diabetes and prediabetes, HGI displays a U-shaped relationship with CVD, heart attack, and CHF risks, with threshold values of -0.14, -0.45, and − 0.14, respectively. HGI may serve as a more effective indicator for identifying populations at early risk for cardiovascular disease.https://doi.org/10.1186/s13098-025-01754-0Hemoglobin glycation indexHGIDiabetesPrediabetesCardiovascular diseaseCVD
spellingShingle Zheng Wang
Fachao Shi
Long Wang
Caoyang Fang
The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study
Diabetology & Metabolic Syndrome
Hemoglobin glycation index
HGI
Diabetes
Prediabetes
Cardiovascular disease
CVD
title The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study
title_full The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study
title_fullStr The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study
title_full_unstemmed The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study
title_short The relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes: a population-based cohort study
title_sort relationship between hemoglobin glycation index and the risk of cardiovascular disease in populations with diabetes or prediabetes a population based cohort study
topic Hemoglobin glycation index
HGI
Diabetes
Prediabetes
Cardiovascular disease
CVD
url https://doi.org/10.1186/s13098-025-01754-0
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