Authors
Yiting Xu, Qi Li, Ming Wang, Tingting Hu, Chunfang Wang, Yun Shen, Liang Wu, Ronghui Du, Yufei Wang, Xiaojing Ma, Tian Xia, Yuqian Bao
Published in
Diabetes research and clinical practice. Pages 113603. Oct 06, 2026. Epub Oct 06, 2026.
Abstract
To explore the association between the glycated albumin to hemoglobin A1c (GA/HbA1c) ratio and all-cause and cardiovascular mortality among adults with type 2 diabetes.
We used data from the PREMIRE cohort, which was established among patients with type 2 diabetes using electronic health records. The baseline GA/HbA1c ratio was calculated from the first available measurements of GA and HbA1c during the patient's initial visit to the hospital for type 2 diabetes.
The study included 20,012 participants, and 3,293 deaths occurred, including 1,313 cardiovascular deaths over a median follow-up of 3.39 years. The GA/HbA1c ratio serves as a robust predictor of mortality, offering superior discriminative ability compared with GA or HbA1c alone. RCS analysis revealed a U-shaped association between the ratio and mortality. The ratio > 3.00 was associated with increased all-cause [HR 1.60 (95% CI, 1.49-1.73)] and cardiovascular mortality [HR 1.61 (95% CI, 1.43-1.81)], while the ratio < 2.00 was also associated with higher all-cause [HR 1.89 (95% CI, 1.64-2.18)] and cardiovascular mortality [HR 1.61 (95% CI, 1.26-2.06)]. The association is further validated in the National Health and Nutrition Examination Survey 1999-2004.
The GA/HbA1c ratio was significantly and independently associated with both all-cause and cardiovascular mortality, following a U-shaped pattern.
PMID:
42838140
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.
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