High hemoglobin glycation index is linked to incident stroke
High glycation index was associated with increased stroke risk at an adjusted hazard ratio of 1.392, which remained 1.333 after HbA1c adjustment.
Research Square
In a prospective cohort of 10,643 stroke-free adults aged 45 years or older from the China Health and Retirement Longitudinal Study, researchers evaluated whether the hemoglobin glycation index (HGI) predicted incident stroke over a median follow-up of about nine years. HGI reflects the gap between measured HbA1c and levels predicted from fasting plasma glucose.
In the complete-case analysis of 8,684 participants, high HGI—at or above the 90th percentile—was associated with higher stroke risk (adjusted hazard ratio 1.392). This link persisted after adjusting for HbA1c (hazard ratio 1.333) and was stronger among participants without diabetes (hazard ratio 1.478). However, discrimination did not differ significantly from HbA1c or fasting glucose alone.
Why it matters
Individual differences in glycation propensity may reflect aspects of metabolic and vascular aging that standard blood glucose metrics overlook. If validated, tracking this divergence could help identify stroke vulnerability in people whose standard glycemic markers appear normal.
Caveats
The findings rely on an observational design with stroke outcomes based on self-reported physician diagnoses. The work is also a preprint that has not yet undergone peer review.
The paper
People's Hospital of Deyang City
Research Square · 1 Oct 2026 · Preprint, not peer-reviewed