Ann Pediatr Endocrinol Metab.  2018 Dec;23(4):196-203. 10.6065/apem.2018.23.4.196.

Association between hemoglobin glycation index and cardiometabolic risk factors in Korean pediatric nondiabetic population

• Lee B
• Heo YJ
• Lee YA
• Lee J
• Kim JH
• Lee SY
• Shin CH
• Yang SW

• KMID: 2432282
• DOI: http://doi.org/10.6065/apem.2018.23.4.196

Abstract

PURPOSE
The hemoglobin glycation index (HGI) represents the degree of nonenzymatic glycation and has been positively associated with cardiometabolic risk factors (CMRFs) and cardiovascular disease in adults. This study aimed to investigate the association between HGI, components of metabolic syndrome (MS), and alanine aminotransferase (ALT) in a pediatric nondiabetic population.
METHODS
Data from 3,885 subjects aged 10-18 years from the Korea National Health and Nutrition Examination Survey (2011-2016) were included. HGI was defined as subtraction of predicted glycated hemoglobin (HbA1(c)) from measured HbA1(c). Participants were divided into 3 groups according to HGI tertile. Components of MS (abdominal obesity, fasting glucose, triglycerides, high-density lipoprotein cholesterol, and blood pressure), and proportion of MS, CMRF clustering (≥2 of MS components), and elevated ALT were compared among the groups.
RESULTS
Body mass index (BMI) z-score, obesity, total cholesterol, ALT, abdominal obesity, elevated triglycerides, and CMRF clustering showed increasing HGI trends from lower-to-higher tertiles. Multiple logistic regression analysis showed the upper HGI tertile was associated with elevated triglycerides (odds ratio, 1.65; 95% confidence interval, 1.18-2.30). Multiple linear regression analysis showed HGI level was significantly associated with BMI z-score, HbA1(c), triglycerides, and ALT. When stratified by sex, age group, and BMI category, overweight/obese subjects showed linear HGI trends for presence of CMRF clustering and ALT elevation.
CONCLUSIONS
HGI was associated with CMRFs in a Korean pediatric population. High HGI might be an independent risk factor for CMRF clustering and ALT elevation in overweight/obese youth. Further studies are required to establish the clinical relevance of HGI for cardiometabolic health in youth.

Keyword

Glycated hemoglobin; Hemoglobin glycation index; Risk factor; Alanine aminotransferase; Metabolic syndrome; Hepatic steatosis

MeSH Terms

Adolescent
Adult
Alanine Transaminase
Body Mass Index
Cardiovascular Diseases
Cholesterol
Fasting
Glucose
Hemoglobin A, Glycosylated
Humans
Korea
Linear Models
Lipoproteins
Logistic Models
Nutrition Surveys
Obesity
Obesity, Abdominal
Risk Factors*
Triglycerides
Alanine Transaminase
Cholesterol
Glucose
Lipoproteins
Triglycerides

Figure

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  Fig. 1. Flow chart of eligible study population. KNHANES, the Korea National Health and Nutrition Examination Survey; HbA1c, glycated hemoglobin; DM, diabetes mellitus.

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  Fig. 2. Association between glycated hemoglobin and fasting plasma glucose among eligible participants.

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  Fig. 3. Cumulative proportion of glycated hemoglobin (HbA1c) by tertiles of hemoglobin glycation index.

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  Fig. 4. Proportions of metabolic syndrome (A), cardiometabolic risk factor (CMRF) clustering (B), and elevated alanine aminotransferase (ALT) (C) by hemoglobin glycation index (HGI) tertiles.

Reference

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