Background Cardiovascular diseases have far-reaching consequences, lacking predictive indicators for early intervention. Diabetes is one of the main causes of cardiovascular and cerebrovascular diseases, and the hemoglobin glycation index (HGI) can reflect the individual glycation ability.

Objective To investigate the relationship between hemoglobin glycation index (HGI) and non-fatal cardiovascular and cerebrovascular diseases in general population and different glucose metabolism populations.

Methods This study was a cross-sectional study, including 16 470 subjects from the Beijing branch of the REACTION study, general characteristics of subjects and the occurrence of non-fatal myocardial infarction, non-fatal stroke (ischemic stroke and hemorrhagic stroke), and other non-fatal cardiovascular diseases were collected. The subjects were divided into four groups based on the baseline HGI quartile cut-off points in the overall population. Logistic regression analysis was used to explore the relationship between HGI and non-fatal cardiovascular diseases.

Results The 16 470 subjects were divided into Q1 (≤-0.26, n=4242), Q2 (-0.26 to -0.02, n=3915), Q3 (-0.02 to 0.24, n=4223), and Q4 ( ＞0.24, n=4090) groups. After grouping by glucose metabolism status, there were 9 710 individuals with normal glucose tolerance (NGT), 4 273 individuals with prediabetes (impaired glucose tolerance, impaired fasting glucose, IGT + IFG), and 2 487 individuals with diabetes mellitus (DM). In the overall population, the occurrence of non-fatal cardiovascular and cerebrovascular diseases increased gradually from Q1 to Q4 as HGI increased, with rates of 3.1%, 3.2%, 4.0%, and 4.3%, respectively (P=0.008). In the NGT group, the occurrence of non-fatal cardiovascular and cerebrovascular diseases increased from Q1 to Q4, with rates of 2.5%, 2.5%, 3.5%, and 3.4%, respectively, showing an upward trend (P=0.046). However, in the IGT + IFG and DM groups, there was no significant difference in the occurrence of non-fatal cardiovascular and cerebrovascular diseases among the HGI groups (P=0.054, 0.523). After adjusting for relevant factors using logistic regression models, the results showed no significant correlation between HGI and non-fatal cardiovascular and cerebrovascular diseases in the overall population, NGT group, and DM group. In the IGT + IFG group, compared to the Q1 group, the risk of non-fatal cardiovascular and cerebrovascular diseases increased in the Q2 group (OR=1.762, 95% CI: 1.098-2.825, P=0.019), Q3 group (OR=2.005, 95% CI: 1.272-3.160, P=0.003), and Q4 group (OR=1.513, 95% CI: 0.941-2.432, P=0.087).

Conclusion In the IGT + IFG group, there is a significant correlation between HGI and non-fatal cardiovascular and cerebrovascular diseases, while no correlation found in the NGT and DM groups.