Hemoglobin glycation index in relationship to the risk of cardiovascular complication in patients with type 2 diabetes: A systematic review and meta-analysis

Abstract Aim To estimate the association of hemoglobin glycation index (HGI) level with total mortality and cardiovascular complication risk among patients with T2DM. Methods Literatures evaluating the associations of HGI with the risk of cardiovascular outcomes and total mortality in patients with T2DM were systematically searched by using the PubMed and Embase databases from January 2002 to April 2019. Fixed-effects model and random-effects model meta-analyses were used to calculate pooled adjusted hazard ratios (HRs). Results Six prospective cohort studies and one nest case-control study (comprising n = 37,280) were included in this systematic review. T2DM patients with high HGI level had significant high HRs (95% confidence interval, 95% CI) for cardiovascular complication [1.25 (1.16, 1.36)] and total mortality [1.26 (1.14, 1.39)] compared to intermediate HGI level. For every 1-unit increment in HGI, the average HR (95% CI) were 1.20 (1.00, 1.41) for cardiovascular complication and 1.13 (1.06, 1.19) for total mortality. Conclusions The findings suggested that a rising HGI level was associated with the increased risk for cardiovascular complication and total mortality among patients with T2DM.