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A recent study confirms the link between higher hemoglobin glycation index levels and the risk of developing non-alcoholic fatty liver disease in patients with type 2 diabetes. For healthcare providers, understanding this association may offer a novel avenue for identifying patients at higher risk for liver disease.

  • Higher hemoglobin glycation index levels were significantly associated with a higher risk of developing non-alcoholic fatty liver disease in patients with type 2 diabetes.
  • This link persisted even after adjusting for traditional risk factors like body mass index, diastolic blood pressure, and liver enzyme levels.
  • Clinical evaluation might benefit from including the hemoglobin glycation index as an additional marker, given the limitations of solely relying on glycated hemoglobin levels.

A cross-sectional study published in the Journal of Diabetes Investigation found that the hemoglobin glycation index (HGI) serves as a meaningful marker to predict the risk of developing non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes. The study involved 3,191 adults and found that those in the highest tertile of HGI levels were 1.40 times more likely to develop NAFLD compared to those with lower levels.

HGI: Beyond HbA1c in Risk Prediction

Traditionally, glycated hemoglobin (HbA1c) has been used to monitor glycemic control in patients with diabetes. However, this marker has limitations due to its sensitivity to various factors, like red blood cell lifespan. The HGI, which reflects the difference between actual measured HbA1c and the predicted levels based on fasting glucose, adds an additional layer of precision. According to the study, integrating HGI into clinical evaluations can help prevent misinterpretations of glycemic assessments and inappropriate treatment decisions.

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Broader Implications for Diabetic Comorbidities

Earlier studies have linked HGI to other diabetic comorbidities, including cardiovascular events and nephropathy. This new study adds to the evidence, indicating that close monitoring of HGI could be crucial in managing not just glycemic control but also associated complications.

A Call to Integrate HGI in Clinical Practice

Given the rising global prevalence of NAFLD, particularly among type 2 diabetes patients, the findings of this study could have significant clinical implications. Clinicians might consider incorporating HGI as an additional marker in routine assessments for patients with diabetes, especially those at higher risk for NAFLD. By doing so, healthcare providers could offer more targeted interventions, which could help reduce morbidity and mortality associated with NAFLD in the population with diabetes.


Wang, M., Li, S., Zhang, X., Li, X., & Cui, J. (2023). Association between hemoglobin glycation index and non‐alcoholic fatty liver disease in the patients with type 2 diabetes mellitus. Journal of Diabetes Investigation. https://doi.org/10.1111/jdi.14066