We investigated the association between postchallenge glucose increment and hemoglobin glycation index (HGI), the difference between observed and predicted glycated hemoglobin (HbA1c), in subjects with no history of diabetes. We enrolled 1381 subjects who attended our outpatient clinic for an oral glucose tolerance test (OGTT) to screen for diabetes. HGI was defined as observed HbA1c minus predicted HbA1c. The predicted HbA1c was calculated by entering fasting plasma glucose (FPG) level into an equation [HbA1c(%)=FPG(mg/dL)*0.029+2.9686] determined from an HbA1c versus FPG regression analysis using data from an independent cohort of 2734 subjects with no history of diabetes. The association between 2-hour glucose increment and HGI was analyzed using linear regression analyses with adjustment of relevant parameters. Overall, the proportions of subjects with normal glucose tolerance, pre-diabetes, and newly diagnosed diabetes were 42.3%, 41.3%, and 16.4%, respectively. Compared with subjects who had an HGI≤0, subjects with an HGI>0 had a lower FPG (95.0±13.3 vs 98.5±15.3 mg/dL, p<0.001) but a higher 2-hour plasma glucose (151.1±52.8 vs 144.6±51.4 mg/dL, p=0.027) and 2-hour glucose increment (56.1±46.1 vs 46.1±45.0 mg/dL, p<0.001). The 2-hour glucose increment after an OGTT was independently associated with HGI (β coefficient 0.003, 95% CI 0.002 to 0.003, p<0.001). Our findings suggested that postchallenge glucose increment was independently associated with HGI in subjects with no history of diabetes.
- glycated hemoglobin A
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Contributors JSW, WJL, and WHHS designed the research. JSW, ITL, SYL, WLL, and KWL conducted the research and collected the data. JSW and WLL analyzed the data. JSW, ITL, and WHHS wrote the first draft of the manuscript. WJL, SYL, WLL and KWL revised the manuscript critically for important intellectual content. All authors approved the final draft of the manuscript.
Funding This study was supported by Taichung Veterans General Hospital, Taichung, Taiwan (TCVGH-YM1070102 and TCVGH-1073505C, 2018; TCVGH-1083505C, 2019).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study protocol was reviewed and approved by the Institutional Review Boards of Taichung Veterans General Hospital, Taichung, Taiwan (approval number C08215B). This study was conducted in accordance with the Declaration of Helsinki, and written informed consent was provided by all subjects prior to the procedures.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. Data cannot be made publicly available due to the ‘Personal Information Protection Act’.
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