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. 2025 May 29:16:1586309.
doi: 10.3389/fendo.2025.1586309. eCollection 2025.

Hemoglobin glycation index and all-cause mortality in adults: insights from a decade-long prospective cohort study

Yue-Yang Zhang #  1   2   3   4   5 , Wen-Yan Li #  1   2   3   4   5   6 , Qin Wan  1   2   3   4   5
Affiliations

Hemoglobin glycation index and all-cause mortality in adults: insights from a decade-long prospective cohort study

Yue-Yang Zhang et al. Front Endocrinol (Lausanne). .

Abstract

Background: The hemoglobin glycation index (HGI), an indicator of individual differences in glucose metabolism. This study undertakes a detailed 10-year cohort analysis to investigate the potential association between HGI and all-cause mortality in a Chinese adult population.

Methods: Baseline data encompassing lifestyle and metabolic parameters were collected from 10,008 participants, with a subsequent 10-year follow-up. Following exclusions based on predefined criteria, 9,084 individuals were included in the final analysis. Participants were categorized into quartiles based on their HGI values. A suite of statistical tools, including Kaplan-Meier survival analysis, Cox proportional hazards models, restricted cubic splines (RCS), threshold effect models, and subgroup analyses, was employed to investigate the association between HGI and all-cause mortality.

Results: During the 10-year follow-up period, a total of 514 all-cause mortality cases were recorded. Kaplan-Meier survival analysis identified the Q2 group as having the lowest mortality rate. Fully adjusted Cox proportional hazards models demonstrated significant associations, indicating higher all-cause mortality risks in participants with both extremely low and high HGI levels compared to the Q2 group. RCS analysis further illustrated a U-shaped relationship between HGI and all-cause mortality.

Conclusions: In the Chinese population, both markedly elevated and significantly reduced HGI levels are associated with adverse impacts on long-term survival.

Core tip: The aim of this study was to assess the association of Hemoglobin Glycation Index(HGI) with all-cause mortality in non-type 2 diabetic patients based on a 10-year cohort study from China. After COX regression, restricted cubic spline analysis, and subgroup analyses, it was found that a significant increase or decrease in HGI adversely affected long-term survival.

Keywords: U-shaped correlation; all-cause mortality; hemoglobin glycation index; prospective cohort study; risk fcator.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Kaplan-Meier all-cause mortality survival analysis curve; (B) Results of RCS analysis of the association between HGI and all-cause mortality. Adjusted for age, sex, DBP, SBP, LDL-c, HDL-c, TG, TC, Cr, FBG, HbA1c, smoking status, alcohol consumption, and education level.
Figure 2
Figure 2
Forest plot of subgroup analyses of the relationship between HGI and all-cause mortality. Adjusted for age, sex, DBP, SBP, LDL-c, HDL-c, TG, TC, Cr, FBG, HbA1c, smoking status, alcohol consumption, and education level.
See this image and copyright information in PMC

References

    1. Lee SC, Chan JC. Evidence for DNA damage as a biological link between diabetes and cancer. Chin Med J (Engl). (2015) 128(11). doi: 10.4103/0366-6999.157693 - DOI - PMC - PubMed
    1. Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet Lond Engl. (2021) 396(10267). doi: 10.1016/S0140-6736(20)32374-6 - DOI - PubMed
    1. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Lond Engl. (2023) 402(10397). doi: 10.1016/S0140-6736(23)01301-6 - DOI - PMC - PubMed
    1. Yan Y, Wu T, Zhang M, Li C, Liu Q, Li F. Prevalence, awareness and control of type 2 diabetes mellitus and risk factors in Chinese elderly population. BMC Public Health. (2022) 22(1). doi: 10.1186/s12889-022-13759-9 - DOI - PMC - PubMed
    1. Tinajero MG, Malik VS. An update on the epidemiology of type 2 diabetes: A global perspective. Endocrinol Metab Clin North Am. (2021) 50(3). doi: 10.1016/j.ecl.2021.05.013 - DOI - PubMed

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