Abstract
ObjectiveThis study aimed to compare hemoglobin glycation index (HGI) and glycation gap (GG), markers of the discordance between measured and predicted hemoglobin A1c levels, for predicting all-cause and cardiovascular disease (CVD) mortality in a nationally representative population.MethodsData of 3468 adults were retrieved from the 1999-2004 US National Health and Nutrition Examination Survey. Participants were stratified into four groups based on the median of absolute values of HGI and GG. Associations between HGI, GG and mortality risk were evaluated with Cox proportional hazard model and time-dependent receiver-operating characteristic curves.ResultsOver a median follow-up of 101 months, 733 (12.48%) participants died, of which 210 were from CVD causes. Compared to the HGI-/GG-group, the HGI+/GG+ group had an hazard ratio (95% confidence interval) of 1.36 (1.02-1.82) for all-cause mortality and 1.91 (1.00-3.64) for CVD mortality. Restricted cubic spline curves demonstrated a positively linear relationship between absolute values of HGI, GG and mortality risk. Time-dependent receiver-operating characteristic curves revealed comparable predictive accuracy for HGI and GG, with area under the curve ranged between 0.50 and 0.60 across follow-up periods.ConclusionsCombined HGI and GG assessment may provide guidance on risk stratification and identification of high-risk individuals.