Concordance the hemoglobin glycation index with glycation gap using glycated albumin in patients with type 2 diabetes

Background: The hemoglobin glycation index (HGI) is an index of differences in the glycation of hemoglobin according to blood glucose level. The glycation gap (G-gap) is an empiric measure of the extent of disagreement between hemoglobin A1C (HbA1C) and glycated albumin (GA). The aim of this study was to investigate the extent of agreement between the HGI and G-gap with respect to GA level, and to elucidate factors related to a high HGI. Method: Data were obtained from 105 patients with type 2 diabetes, and fasting blood glucose (FBG), HbAlc, and GA values were measured simultaneously. The G-gap was calculated as the difference between the measured and GA-based predicted HbAlc levels. HGI was calculated as the difference between measured and FBG-based predicted HbAlc levels. Results: The HGI and G-gap were highly correlated according GA (r = 0.722, P < 0.001). In general, the two indices were similar in terms of both direction and magnitude. The classification of patients as high, moderate, or low glycators based on HGI versus G-gap was consistent for the majority of the population and only 5% of patients were reclassified from high to low or low to high. Fasting C-peptide levels decreased linearly, and the percentage of patients using insulin increased linearly, between the lowest and highest HGI tertile (both P < 0.05). Conclusions: There was 95% agreement between the HGI and G-gap using GA among type 2 diabetes patients. Furthermore, a high HGI was associated with a higher prevalence of insulin use among type 2 diabetes patients. (C) 2017 Elsevier Inc. All rights reserved.