Hemoglobin Glycation Index (HGI): Prevalence and Risk Factors for Predicting Diabetic Kidney Disease Among Patients with Type 2 Diabetes Mellitus at Rayong Hospital
Keywords:
Diabetic kidney disease, Hemoglobin Glycation Index, Type 2 diabetes mellitusAbstract
This study aimed to determine the prevalence of diabetic kidney disease (DKD) and evaluate the association between Hemoglobin Glycation Index (HGI) and incident DKD among newly diagnosed patients with type 2 diabetes mellitus. This retrospective cohort study used electronic medical records of newly diagnosed type 2 diabetes mellitus patients between 2018–2019 with 5 years of follow-up. HGI was calculated from the relationship between HbA1c and fasting plasma glucose (FPG) at baseline and categorized into tertiles. Logistic regression was used to analyze the association.
Results: A total of 115 patients were included. Thirty-five patients developed DKD, yielding a 5-year cumulative prevalence of 30.43%. Compared with those without DKD, patients who developed DKD had a significantly higher baseline FPG (173.37±67.41 vs. 136.23±36.34 mg/dL, p<0.01), higher HbA1c (8.21±1.66 vs. 7.47±1.48%, p<0.01), and higher triglyceride levels (178.85±105.69 vs. 134.2±59.31 mg/dL, p<0.01). When categorized by HGI tertiles, no significant association was observed between HGI levels and incident DKD either before or after adjustment for confounders
References
WHO.(2025). Diabetes [Internet]. [cited 2025 Sep 2]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes
MacIsaac RJ, Ekinci EI, Jerums G.(2014). Markers of and Risk Factors for the Development and Progression of Diabetic Kidney Disease. Am J Kidney Dis. 2014 Feb 1;63(2):S39–62. doi:10.1053/j.ajkd.2013.10.048 PubMed PMID: 24461729.
Fenta ET, Eshetu HB, Kebede N, Bogale EK, Zewdie A, Kassie TD, et al.(2023). Prevalence and predictors of chronic kidney disease among type 2 diabetic patients worldwide, systematic review and meta-analysis. Diabetol Metab Syndr. 2023 Nov 28;15:245. doi:10.1186/s13098-023-01202-x PubMed PMID: 38012781; PubMed Central PMCID: PMC10683270.
Hempe JM, Hsia DS.(2022). Variation in the hemoglobin glycation index. J Diabetes Complications. 2022 Jul;36(7):108223. doi:10.1016/j.jdiacomp.2022.108223 PubMed PMID: 35667965.
Makris K, Spanou L.(2011). Is There a Relationship between Mean Blood Glucose and Glycated Hemoglobin? J Diabetes Sci Technol. 2011 Nov 1;5(6):1572–83. doi:10.1177/193229681100500634 PubMed PMID: 22226280; PubMed Central PMCID: PMC3262729.
Hempe JM, Yang S, Liu S, Hsia DS.(2021). Standardizing the haemoglobin glycation index. Endocrinol Diabetes Metab. 2021 Sep 23;4(4):e00299. doi:10.1002/edm2.299 PubMed PMID: 34558807; PubMed Central PMCID: PMC8502217.
Wang S, Song S, Gao J, Duo Y, Gao Y, Fu Y, et al.(2024). Glycated haemoglobin variability and risk of renal function decline in type 2 diabetes mellitus: An updated systematic review and meta-analysis. Diabetes Obes Metab. 2024;26(11):5167–82. doi:10.1111/dom.15861
Zhou W, Zhang L, Liu T.(2025). Association Between the Hemoglobin Glycation Index (HGI) and Risk of Diabetic Nephropathy: A Retrospective Cohort Study. Diabetes Metab Syndr Obes. 2025 Jun 5;18:1859–72. doi:10.2147/DMSO.S523442
Xin S, Zhao X, Ding J, Zhang X.(2023). Association between hemoglobin glycation index and diabetic kidney disease in type 2 diabetes mellitus in China: A cross- sectional inpatient study. Front Endocrinol. 2023;14:1108061. doi:10.3389/fendo.2023.1108061 PubMed PMID: 36967789; PubMed Central PMCID: PMC10031087.
Hoogeveen EK.(2022). The Epidemiology of Diabetic Kidney Disease. Kidney Dial. 2022 Sep;2(3):433–42. doi:10.3390/kidneydial2030038
Martínez-Montoro JI, Aparicio-Sánchez JJ, Pimentel B, Juárez-Campo M, Alamillo ML, Fernández-García JC. (2025). Screening, prevalence, and burden of chronic kidney disease in people with type 2 diabetes managed by endocrinologists: A nationwide cross-sectional study. Diabetes Res Clin Pract. 2025 Aug 1;226:112326. doi:10.1016/j.diabres.2025.112326
Liu J, Ma Y, Yu G, Wang W.(2023). Trajectories of Fasting Plasma Glucose and Risks of Chronic Kidney Disease in a General Chinese Population: A Retrospective Study. Int J Gen Med. 2023 Dec 5;16:5695–702. doi:10.2147/IJGM.S435451
Rizk J, Soohoo M, Hashemi L, Arif Y, Hsiung JT, Marroquin M, et al.(2021). Abstract 10683: Association Between Triglycerides and Incident Chronic Kidney Disease in Diabetics Across Stages of Albuminuria. Circulation. 2021 Nov 16;144(Suppl_1):A10683–A10683. doi:10.1161/circ.144.suppl_1.10683
Gong L, Wang C, Ning G, Wang W, Chen G, Wan Q, et al.(2021). High concentrations of triglycerides are associated with diabetic kidney disease in new‐onset type 2 diabetes in China: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study. Diabetes Obes Metab. 2021 Nov;23(11):2551–60. doi:10.1111/dom.14502 PubMed PMID: 34322974; PubMed Central PMCID: PMC9291490.
Kim W, Go T, Kang DR, Lee EJ, Huh JH.(2021). Hemoglobin glycation index is associated with incident chronic kidney disease in subjects with impaired glucose metabolism: A 10-year longitudinal cohort study. J Diabetes Complications. 2021 Jan;35(1):107760. doi:10.1016/j.jdiacomp.2020.107760 PubMed PMID: 33077349.
Nakasone Y, Miyakoshi T, Sakuma T, Toda S, Yamada Y, Oguchi T, et al.(2024). Hemoglobin Glycation Index: A Novel Risk Factor for Incident Chronic Kidney Disease in an Apparently Healthy Population. J Clin Endocrinol Metab. 2024 Mar 1;109(3):e1055–60. doi:10.1210/clinem/dgad638
