Hemoglobin glycation index can be used as a predictor of diabetes mellitus and prediabetes: a cohort study.

BACKGROUND: Diabetes mellitus (DM) is a significant global public health concern, with prediabetes serving as a critical stage between normoglycemia and DM. Without intervention, individuals with prediabetes face an increased risk of developing DM, underscoring the need for effective preventive measures. The Hemoglobin Glycation Index (HGI)-which measures the discrepancy between actual and predicted glycated hemoglobin (HbA1c) levels-has shown promise in predicting the onset of both microvascular and macrovascular complications associated with DM. However, its potential role in assessing the risk of developing DM or prediabetes remains to be fully established. This study aims to investigate the predictive capacity of HGI for both DM and prediabetes. METHOD: This retrospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), involving participants aged 45 years and older who were assessed in 2011 and followed up in 2015. Univariate and multivariate logistic regression models were employed to analyze the relationship between HGI and the incidence of prediabetes and DM. Dose-response analyses were conducted using restricted cubic splines, and subgroup analyses were performed based on various demographic and health-related factors. RESULTS: Among 3,963 participants, 187 individuals (4.72%) developed prediabetes within four years, and 107 individuals (2.70%) developed DM. HGI was independently associated with an increased risk of developing both DM and prediabetes, with adjusted odds ratios of 1.61 (95% confidence interval [CI]: 1.19-2.16, p = 0.001) and 2.03 (95% CI: 1.40-2.94, p < 0.001), respectively. A linear relationship was observed between HGI and both DM and prediabetes. An interaction effect was identified between age and HGI; specifically, the association between higher HGI and incident DM was more pronounced in individuals aged 45 to 60 years. Among this age group, the OR was 3.93 (95% CI: 2.19-7.05, p < 0.001). CONCLUSION: HGI is identified as an independent risk factor for both DM and prediabetes, demonstrating its utility in predicting the likelihood of their development, particularly within the population aged 45 to 60. These findings highlight the potential of HGI as a valuable biomarker for the early identification of DM risk, thereby facilitating the formulation of targeted intervention strategies. TRIAL REGISTRATION: Not applicable.