High hemoglobin glycation index is linked to stroke risk
In middle-aged and older adults, high hemoglobin glycation index was associated with incident stroke (adjusted hazard ratio 1.392), persisting after HbA1c adjustment (hazard ratio 1.333).
Research Square
In a prospective study of 10,643 stroke-free Chinese adults aged 45 years or older from the China Health and Retirement Longitudinal Study, researchers examined whether the hemoglobin glycation index predicts incident stroke. The index quantifies the difference between measured HbA1c and HbA1c predicted from fasting blood glucose levels.
Over a median follow-up of about 9 years, 841 participants developed stroke. In a complete-case analysis of 8,684 individuals with 699 events, high hemoglobin glycation index (at or above the 90th percentile) was associated with higher stroke risk (adjusted hazard ratio 1.392). This association remained after adjusting for HbA1c (hazard ratio 1.333) and was stronger among participants without diabetes (hazard ratio 1.478). However, predictive discrimination did not differ significantly among five compared glycemic indices, with C-indices between 0.658 and 0.663.
Why it matters
The findings suggest that individual variation in glycation propensity contributes to vascular risk independently of standard blood glucose measurements.
Caveats
This observational study is a preprint that has not undergone peer review, relies on self-reported physician diagnoses, and notes limited stand-alone predictive value for the index.
The paper
People's Hospital of Deyang City
Research Square · 1 Oct 2026 · Preprint, not peer-reviewed