Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study

Abstract The relationship between HGI and mortality in patients with diabetes or prediabetes who have comorbid CVD has not yet been clearly established. Therefore, the aim of this study was to investigate the correlation between baseline HGI and all-cause and cardiovascular mortality in US adults wi...

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Main Authors: Fachao Shi, Zhe Yang, Zheng Wang, Long Wang, Caoyang Fang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-07743-7
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author Fachao Shi
Zhe Yang
Zheng Wang
Long Wang
Caoyang Fang
author_facet Fachao Shi
Zhe Yang
Zheng Wang
Long Wang
Caoyang Fang
author_sort Fachao Shi
collection DOAJ
description Abstract The relationship between HGI and mortality in patients with diabetes or prediabetes who have comorbid CVD has not yet been clearly established. Therefore, the aim of this study was to investigate the correlation between baseline HGI and all-cause and cardiovascular mortality in US adults with diabetes or prediabetes and comorbid CVD. This study analyzed data from 1,760 patients with diabetes or prediabetes and comorbid CVD from the NHANES from 1999 to 2018. Three models were constructed considering covariates to evaluate the correlation between HGI and mortality risk. Additionally, we used RCS and threshold effects to analyze the nonlinear relationship. During the follow-up of 1,760 patients with diabetes or prediabetes and comorbid CVD, there were 793 all-cause deaths and 274 cardiovascular-related deaths recorded. Restricted cubic spline analysis results showed that baseline HGI was U-shapedly associated with all-cause and cardiovascular mortality rates. Threshold effect analysis indicated that the turning points of HGI for all-cause and cardiovascular mortality rates were − 0.382 and − 0.380, respectively. Specifically, when baseline HGI was below the turning point, HGI was negatively correlated with all-cause mortality rate (HR: 0.6, 95% CI: 0.5–0.7) and cardiovascular mortality rate (HR: 0.6, 95% CI: 0.4-1.0), while when baseline HGI exceeded the turning point, HGI was positively correlated with all-cause mortality rate (HR: 1.2, 95% CI: 1.1–1.4) and cardiovascular mortality rate (HR: 1.3, 95% CI: 1.1–1.5). We found that in US adults with diabetes or prediabetes and comorbid CVD, baseline HGI was U-shapedly associated with all-cause and cardiovascular mortality rates. Specifically, the turning points for all-cause and cardiovascular mortality rates were − 0.382 and − 0.380, respectively.
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spelling doaj-art-b2b9ea89e0ff43e48e6565e1bf13d84d2025-08-20T03:38:15ZengNature PortfolioScientific Reports2045-23222025-07-0115111210.1038/s41598-025-07743-7Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort studyFachao Shi0Zhe Yang1Zheng Wang2Long Wang3Caoyang Fang4Department of Cardiology, Ma’anshan People’s Hospital,Ma’anshan Hospital Affiliated to Wannan Medical CollegeDepartment of Emergency, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of ChinaDepartment of Cardiology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical UniversityDepartment of Cardiology, The Second People’s Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical UniversityDepartment of Emergency, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of ChinaAbstract The relationship between HGI and mortality in patients with diabetes or prediabetes who have comorbid CVD has not yet been clearly established. Therefore, the aim of this study was to investigate the correlation between baseline HGI and all-cause and cardiovascular mortality in US adults with diabetes or prediabetes and comorbid CVD. This study analyzed data from 1,760 patients with diabetes or prediabetes and comorbid CVD from the NHANES from 1999 to 2018. Three models were constructed considering covariates to evaluate the correlation between HGI and mortality risk. Additionally, we used RCS and threshold effects to analyze the nonlinear relationship. During the follow-up of 1,760 patients with diabetes or prediabetes and comorbid CVD, there were 793 all-cause deaths and 274 cardiovascular-related deaths recorded. Restricted cubic spline analysis results showed that baseline HGI was U-shapedly associated with all-cause and cardiovascular mortality rates. Threshold effect analysis indicated that the turning points of HGI for all-cause and cardiovascular mortality rates were − 0.382 and − 0.380, respectively. Specifically, when baseline HGI was below the turning point, HGI was negatively correlated with all-cause mortality rate (HR: 0.6, 95% CI: 0.5–0.7) and cardiovascular mortality rate (HR: 0.6, 95% CI: 0.4-1.0), while when baseline HGI exceeded the turning point, HGI was positively correlated with all-cause mortality rate (HR: 1.2, 95% CI: 1.1–1.4) and cardiovascular mortality rate (HR: 1.3, 95% CI: 1.1–1.5). We found that in US adults with diabetes or prediabetes and comorbid CVD, baseline HGI was U-shapedly associated with all-cause and cardiovascular mortality rates. Specifically, the turning points for all-cause and cardiovascular mortality rates were − 0.382 and − 0.380, respectively.https://doi.org/10.1038/s41598-025-07743-7All-cause mortalityCardiovascular mortalityDiabetesHaemoglobin glycation indexHGICardiovascular disease
spellingShingle Fachao Shi
Zhe Yang
Zheng Wang
Long Wang
Caoyang Fang
Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study
Scientific Reports
All-cause mortality
Cardiovascular mortality
Diabetes
Haemoglobin glycation index
HGI
Cardiovascular disease
title Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study
title_full Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study
title_fullStr Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study
title_full_unstemmed Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study
title_short Association of hemoglobin glycation index with all-cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease: a population-based cohort study
title_sort association of hemoglobin glycation index with all cause and cardiovascular mortality in patients with diabetes or prediabetes and comorbid cardiovascular disease a population based cohort study
topic All-cause mortality
Cardiovascular mortality
Diabetes
Haemoglobin glycation index
HGI
Cardiovascular disease
url https://doi.org/10.1038/s41598-025-07743-7
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