Gram Research analysis of 2,342 Saudi teens found that adolescents with higher hemoglobin glycation index (HGI) scores were less likely to have metabolic syndrome, a cluster of heart and diabetes risk factors. Metabolic syndrome affected 43.3% of participants, but the link was unadjusted and cross-sectional, so it does not prove cause.
Gram Research analysis of a 2026 study looked at how a blood test called the Hemoglobin Glycation Index, or HGI, relates to metabolic syndrome in teens. Metabolic syndrome is a group of health warning signs, including high blood pressure, high blood sugar, extra belly fat, and unhealthy cholesterol, that raises the risk of heart disease and type 2 diabetes. Researchers tested 2,342 students aged about 12 to 18 in Riyadh, Saudi Arabia. Metabolic syndrome was found in 43.3% of them. Surprisingly, teens with higher HGI scores were less likely to have metabolic syndrome. This is the opposite of what is usually seen in adults. Because the study only took one snapshot in time and did not account for other factors, it cannot show that HGI causes or prevents these problems. More research is needed.
Key Statistics
A 2026 cross-sectional study of 2,342 Saudi adolescents in Riyadh found that metabolic syndrome was present in 43.3% of participants.
In the same study, metabolic syndrome was more common in boys than girls, affecting 47.1% of boys compared with 40.9% of girls.
Researchers found that teens with metabolic syndrome had slightly lower average HGI scores (-0.057) than teens without it (-0.003), with the largest difference seen among girls.
The Quick Take
- What they studied: Researchers wanted to know whether a blood marker called the Hemoglobin Glycation Index, which compares two blood sugar measures, is connected to metabolic syndrome in teenagers.
- Who participated: 2,342 Saudi teenagers from secondary schools in Riyadh, including 893 boys and 1,449 girls, with an average age of about 14.8 years. They were recruited between September 2019 and March 2021.
- Key finding: Metabolic syndrome affected 43.3% of the teens, and it was more common in boys (47.1%) than girls (40.9%). Teens with higher HGI scores were less likely to have metabolic syndrome, a result that runs opposite to most adult studies.
- What it means for you: This study does not yet tell parents or teens what to do with HGI results. Anyone worried about metabolic syndrome should talk with a doctor, who can check blood pressure, blood sugar, cholesterol, and body weight directly.
The Research Details
This was a cross-sectional study, which means researchers took a single snapshot of many people at one point in time. They did not follow the teens over the years to see who later developed health problems. Students were recruited from schools in Riyadh between 2019 and 2021.
Each participant had their height, weight, and waist measured, along with their blood pressure. Blood samples were taken to measure fasting blood sugar, a standard three-month blood sugar test called HbA1c, cholesterol and fats in the blood, and vitamin D. HGI was calculated by comparing each teen’s actual HbA1c with the HbA1c level that would be expected based on their fasting blood sugar. A teen with a higher-than-expected HbA1c has a higher HGI score.
Metabolic syndrome was identified using pediatric guidelines, which look at a set of measurements such as waist size, blood pressure, blood sugar, and cholesterol levels. The researchers then compared HGI levels across groups and examined how the two were related.
A snapshot study is a useful first step because it can reveal patterns across a large group quickly and at low cost. It can show whether two things tend to appear together, which helps scientists decide what to investigate next. However, a snapshot cannot show which came first or whether one causes the other. That is why the authors stress that these findings are a starting point rather than a final answer.
The study included a fairly large group of 2,342 teens, and it used standard medical criteria to define metabolic syndrome. The researchers also measured many health markers in each participant, which adds credibility. On the other hand, the main comparisons were unadjusted, meaning they did not account for factors such as age, puberty stage, body weight, or family background. The study was also conducted in one city, so its results may not apply to all teens. Readers should treat the findings as preliminary.
What the Results Show
Metabolic syndrome was present in 43.3% of the teens in the study. Boys were somewhat more likely to have it than girls, at 47.1% compared with 40.9%.
Teens with metabolic syndrome had higher body mass index, higher blood pressure, higher triglycerides (a type of blood fat), and higher fasting blood sugar. They also had lower levels of HDL cholesterol, often called the good cholesterol, and lower vitamin D. These differences were all statistically clear, meaning they were unlikely to be due to chance.
The unexpected result involved HGI. Teens with metabolic syndrome had slightly lower average HGI scores than teens without it, at about -0.057 compared with about -0.003. The gap was largest among girls. When researchers grouped teens into three levels based on HGI, those in the higher groups were less likely to have metabolic syndrome than those in the lowest group.
These results suggest that in teens, a higher HGI does not appear to signal greater metabolic risk in the same way it does in many adult studies. The reasons for this are not yet clear.
Correlation analyses, which measure how closely two things move together, showed different patterns for boys and girls. However, most links between HGI and other health measures were weak. This means HGI alone is unlikely to predict a teen’s specific blood pressure, cholesterol, or weight. The findings highlight that boys and girls may respond differently to the same blood markers, which is a useful clue for future research.
Many studies in adults have linked a higher HGI with higher risk of diabetes and heart disease. Those studies generally found that people with higher HGI scores had worse metabolic health. This adolescent study does not match that pattern, which suggests that the relationship between blood sugar markers and metabolic health may change with age, growth, and puberty. Previous research on HGI in young people has been limited, so this study adds to a small but growing body of evidence.
The biggest limitation is that the study is cross-sectional, so it cannot show cause and effect or track changes over time. The main results were not adjusted for other factors that influence metabolic health, such as puberty stage, body fat distribution, diet, physical activity, or family history. Puberty can strongly affect blood sugar and red blood cell turnover, and these were not fully measured. Participants came from one city, which limits how broadly the results apply. The authors also note that longer studies measuring insulin resistance and inflammation are needed to understand the biology behind these findings.
The Bottom Line
Based on this single study, there is not enough evidence to recommend using HGI to assess metabolic risk in teenagers. Confidence in the current findings is low to moderate because the study was a snapshot and did not adjust for key factors. The strongest, most consistent advice remains the established one: healthy eating, regular physical activity, adequate sleep, and routine checkups to monitor blood pressure, blood sugar, and cholesterol.
Parents, teens, school health staff, and clinicians who work with adolescents may find this research interesting because it challenges assumptions taken from adult studies. Researchers studying blood sugar markers in young people will also find it useful. People who are not involved in youth health, or who need a clear answer about their own risk, should not change their care based on this study alone.
Because this is a single snapshot, the findings cannot tell anyone how quickly their health might change. Lifestyle changes such as more physical activity and better eating patterns often improve blood pressure, cholesterol, and blood sugar over several weeks to months. Any change in HGI as a useful risk marker would require years of follow-up research before it could guide everyday care.
Frequently Asked Questions
What is the hemoglobin glycation index and why do researchers study it?
The hemoglobin glycation index compares a person’s measured three-month blood sugar marker with the level predicted from their daily fasting blood sugar. Researchers study it because it may reveal hidden differences in how the body handles blood sugar, though its link to health risk is still being clarified.
How common is metabolic syndrome in Saudi teenagers?
A 2026 study of 2,342 Saudi adolescents in Riyadh found that 43.3% had metabolic syndrome. Boys were affected at 47.1%, compared with 40.9% of girls. The condition involves a group of warning signs such as high blood pressure and high blood sugar.
Does a higher HGI mean a teen has a higher risk of metabolic syndrome?
In this teen study, higher HGI scores were linked to lower odds of metabolic syndrome, which is the opposite of most adult findings. Because the study was a single snapshot without full adjustments, it cannot confirm a cause or determine what HGI means for an individual teen.
What can teenagers do to lower their risk of metabolic syndrome?
Established steps include regular physical activity, eating plenty of vegetables and whole foods, limiting sugary drinks, getting enough sleep, and keeping up with routine checkups. A doctor can measure blood pressure, cholesterol, and blood sugar to track a teen’s individual risk.
Want to Apply This Research?
- Track weekly averages of waist circumference, resting blood pressure, and daily minutes of moderate activity, and log them alongside any lab results a doctor shares. Users can record values each week and review trends monthly.
- Encourage users to aim for at least 60 minutes of moderate activity most days, add one extra serving of vegetables to two meals daily, and limit sugary drinks to occasional treats. Reminders can help build these habits gradually.
- Use the app to keep a long-term record of routine checkup results, including blood pressure, weight, waist size, and any lab tests a doctor orders. Review trends with a healthcare provider once or twice a year rather than making decisions from a single reading.
This article summarizes a single cross-sectional study of teenagers in Saudi Arabia and is for general information only. It does not provide medical advice, diagnosis, or treatment. The study cannot prove that any blood marker causes or prevents metabolic syndrome. Parents and teens should talk with a qualified healthcare provider before making decisions about testing, diet, exercise, or medication.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.