Abstract
Background: Hemoglobin glycation index (HGI) is used to describe the difference between estimated and measured glycated hemoglobin (HbA1c). Aim: We aimed to study whether HGI can predict the progression of chronic kidney disease (CKD) in patients with type 2 diabetes. Method: This cohort study enrolled 538 patients with type 2 diabetes. Participants were divided into the low and high HGI subgroups according to the baseline HGI calculated by fasting blood glucose and HbA1c. One-to-one propensity score matching (269:269) was performed to match age, sex, hypertension, estimated glomerular filtration rate, urine albumin–creatinine ratio, use of renin-angiotensin-aldosterone system blocker, and follow-up period. Survival analysis with Kaplan–Meier method and Cox proportional hazard models with robust standard error were used to evaluate the risk and hazard ratio of progression of clinical CKD stage according to the criteria of kidney disease: improving global outcomes. Results: The participants were followed for a median of 7.3 years. A high HGI was associated with a higher risk of clinical CKD stage progression. The crude hazard ratio (HR) and 95% confidence interval (95% CI) was 1.30 (1.07–1.57). After adjusting for HbA1c quartiles, the HR (95% CI) was 2.24 (1.84–2.74). Discussion: HGI independently predicts the progression of CKD in patients with type 2 diabetes. Further investigations are warranted to elucidate its potential clinical impact.
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