Hemoglobin glycation index predicts renal function deterioration in patients with type 2 diabetes and a low risk of chronic kidney disease

Chih-Hung Lin; Ying-Chuen Lai; Tien-Jyun Chang; Yi-Der Jiang; Yi-Cheng Chang; Lee-Ming Chuang

doi:10.1016/j.diabres.2022.109834

Hemoglobin glycation index predicts renal function deterioration in patients with type 2 diabetes and a low risk of chronic kidney disease

Diabetes Res Clin Pract. 2022 Apr:186:109834. doi: 10.1016/j.diabres.2022.109834. Epub 2022 Mar 18.

Authors

Chih-Hung Lin¹, Ying-Chuen Lai¹, Tien-Jyun Chang², Yi-Der Jiang², Yi-Cheng Chang³, Lee-Ming Chuang⁴

Affiliations

¹ Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan.
² Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan.
³ Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 100, Taiwan; Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan.
⁴ Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan; Institute of Preventive Medicine, School of Public Health, National Taiwan University, Taipei 100, Taiwan. Electronic address: leeming@ntu.edu.tw.

PMID: 35314255
DOI: 10.1016/j.diabres.2022.109834

Abstract

Aims: Hemoglobin glycation index (HGI) is used to describe the difference between estimated and measured glycated hemoglobin (HbA_1c). We aimed to study whether HGI can predict renal function deterioration in patients with type 2 diabetes and a low risk of chronic kidney disease (CKD).

Methods: This retrospective cohort study enrolled 780 patients with type 2 diabetes and a low CKD risk according to the criteria of kidney disease: improving global outcomes. Participants were divided into two subgroups according to the baseline HGI calculated by fasting blood glucose and HbA_1c. Multivariate Cox proportional hazard models were used to evaluate the hazard ratios of the study endpoints. Longitudinal data was analyzed using generalized estimating equation (GEE).

Results: The participants were followed for a median of 7.3 years. A high HGI predicted rapid renal function decline without or with a resultant eGFR < 60 ml/min/1.73 m², but not onset of macroalbuminuria. The longitudinal GEE model demonstrated a negative association between HGI and the predicted eGFR changes in both the 1-year and 3-year intervals.

Conclusions: HGI independently predicted renal function deterioration in patients with type 2 diabetes and a low CKD risk. Further investigations are warranted to elucidate its potential clinical impact.

Keywords: Hemoglobin glycation index; Renal function deterioration; Type 2 diabetes mellitus.

MeSH terms

Diabetes Mellitus, Type 2* / complications
Female
Glycated Hemoglobin / analysis
Hemoglobins
Humans
Kidney / physiology
Male
Renal Insufficiency, Chronic*
Retrospective Studies

Substances

Glycated Hemoglobin A
Hemoglobins