Standardizing the haemoglobin glycation index

• DOI: 10.1002/edm2.299
• Publication Date: 2021-09-23T13:05:07Z
• Authors: James M. Hempe; Shengping Yang; Shuqian Liu; Daniel S. Hsia
• Keywords: Adult; Glycated Hemoglobin; HbA1c; diabetes; Glucose Tolerance Test; haemoglobin glycation index; Diabetes Mellitus, Type 2; NHANES

A high haemoglobin glycation index (HGI) is associated with greater risk for hypoglycaemia and chronic vascular disease. Standardizing how the HGI is calculated would normalize results between research studies and hospital laboratories and facilitate the clinical use of HGI for assessing risk. The HGI is the difference between an observed HbA1c and a predicted HbA1c obtained by inserting fasting plasma glucose (FPG) into a regression equation describing the linear relationship between FPG and HbA1c in a reference population. We used data from the 2005–2016 U.S. National Health and Nutrition Examination Survey (NHANES) to identify a reference population of 18,675 diabetes treatment–naïve adults without self‐reported diabetes. The regression equation derived from this demographically diverse diabetes treatment–naïve adult NHANES reference population is suitable for standardizing how the HGI is calculated for both clinical use and in research to mechanistically explain population variation in the HGI and why a high HGI is associated with greater risk for chronic vascular disease.