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. 2025 Apr 2;24(1):148.
doi: 10.1186/s12933-025-02710-y.

Relationship between hemoglobin glycation index and myocardial mechano-energetic efficiency in non-diabetic individual

Chiara M A Cefalo  1 , Mariangela Rubino  2 , Teresa Vanessa Fiorentino  2 , Velia Cassano  2 , Gaia Chiara Mannino  2 , Alessia Riccio  3 , Elena Succurro  2 , Maria Perticone  2 , Angela Sciacqua  2 , Francesco Andreozzi  2 , Giorgio Sesti  3
Affiliations

Relationship between hemoglobin glycation index and myocardial mechano-energetic efficiency in non-diabetic individual

Chiara M A Cefalo et al. Cardiovasc Diabetol. .

Abstract

Background and aims: The hemoglobin glycation index (HGI) has been linked to cardiovascular disease in diabetic patients. However, it remains unclear whether an elevated HGI similarly affects the cardiovascular system in individuals with normal glucose tolerance or prediabetes. In this cross-sectional study, we aimed to determine whether increased HGI levels are associated with a reduction in myocardial mechano-energetic efficiency (MEE), a key predictor of cardiovascular events and heart failure, in non-diabetic subjects.

Methods: Myocardial MEE per gram of left ventricular mass (MEEi) was assessed via echocardiography in a cohort of 1,074 adults with different glucose tolerance statuses, enrolled in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study. HGI was defined as the difference between the measured HbA1c and the predicted HbA1c, the latter calculated from the linear association between HbA1c and fasting plasma glucose levels.

Results: Subjects in the highest HGI quartile exhibited significantly elevated myocardial oxygen consumption and a marked reduction in MEEi compared to those in the lowest quartile. A significant inverse correlation was observed between HGI and MEEi (r = - 0.210, P < 0.001). A multivariate linear regression analysis confirmed the strong relationship between higher HGI levels and lower MEEi, even after adjusting for several potential confounders, including sex, age, body mass index, waist circumference, smoking status, triglycerides, HDL cholesterol, 2-hour post-load glucose, glucose tolerance status, fasting insulin, HOMA-IR, hs-CRP, antihypertensive therapy, and lipid-lowering therapy.

Conclusions: These findings support the hypothesis that higher HGI values may affect myocardial mechano-energetic efficiency in non-diabetic individuals.

Keywords: Cardiovascular diseases; Echocardiography; Glucose tolerance; Hemoglobin glycation index; Myocardial mechano-energetic efficiency (MEE).

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Association between quartile of HGI and myocardial MEEi values. Quartile 1 ranging from − 1.385 to − 0.211, Quartile 2 ranging from − 0.206 to -0.006; Quartile 3 ranging from − 0.001 to 0.205 and Quartile 4 ranging from 0.206 to 1.136. MEEi = mechano-energetic efficiency per gram of LVM
See this image and copyright information in PMC

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