Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes
Abstract Background Glycemic variability plays an important role in the development of cardiovascular disease (CVD). This study aims to determine whether long-term visit-to-visit glycemic variability is associated with aortic stiffness progression in participants with type 2 diabetes (T2D). Methods...
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| Format: | Article |
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BMC
2023-07-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-023-01884-7 |
| _version_ | 1797784760694603776 |
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| author | Qianhua Fang Juan Shi Jia Zhang Ying Peng Cong Liu Xing Wei Zhuomeng Hu Lin Sun Jie Hong Weiqiong Gu Weiqing Wang Yifei Zhang |
| author_facet | Qianhua Fang Juan Shi Jia Zhang Ying Peng Cong Liu Xing Wei Zhuomeng Hu Lin Sun Jie Hong Weiqiong Gu Weiqing Wang Yifei Zhang |
| author_sort | Qianhua Fang |
| collection | DOAJ |
| description | Abstract Background Glycemic variability plays an important role in the development of cardiovascular disease (CVD). This study aims to determine whether long-term visit-to-visit glycemic variability is associated with aortic stiffness progression in participants with type 2 diabetes (T2D). Methods Prospective data were obtained from 2115 T2D participants in the National Metabolic Management Center (MMC) from June 2017 to December 2022. Two brachial-ankle pulse wave velocity (ba-PWV) measurements were performed to assess aortic stiffness over a mean follow-up period of 2.6 years. A multivariate latent class growth mixed model was applied to identify trajectories of blood glucose. Logistic regression models were used to determine the odds ratio (OR) for aortic stiffness associated with glycemic variability evaluated by the coefficient of variation (CV), variability independent of the mean (VIM), average real variability (ARV), and successive variation (SV) of blood glucose. Results Four distinct trajectories of glycated hemoglobin (HbA1c) or fasting blood glucose (FBG) were identified. In the U-shape class of HbA1c and FBG, the adjusted ORs were 2.17 and 1.21 for having increased/persistently high ba-PWV, respectively. Additionally, HbA1c variability (CV, VIM, SV) was significantly associated with aortic stiffness progression, with ORs ranging from 1.20 to 1.24. Cross-tabulation analysis indicated that the third tertile of the HbA1c mean and VIM conferred a 78% (95% confidence interval [CI] 1.23–2.58) higher odds of aortic stiffness progression. Sensitivity analysis demonstrated that the SD of HbA1c and the highest HbA1c variability score (HVS) were significantly associated with the adverse outcomes independent of the mean of HbA1c during the follow-up. Conclusions Long-term visit-to-visit HbA1c variability was independently associated with aortic stiffness progression, suggesting that HbA1c variability was a strong predictor of subclinical atherosclerosis in T2D participants. |
| first_indexed | 2024-03-13T00:44:29Z |
| format | Article |
| id | doaj.art-5ea2516dce3347b2a26e6ff1ab30258b |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-13T00:44:29Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-5ea2516dce3347b2a26e6ff1ab30258b2023-07-09T11:05:25ZengBMCCardiovascular Diabetology1475-28402023-07-0122111010.1186/s12933-023-01884-7Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetesQianhua Fang0Juan Shi1Jia Zhang2Ying Peng3Cong Liu4Xing Wei5Zhuomeng Hu6Lin Sun7Jie Hong8Weiqiong Gu9Weiqing Wang10Yifei Zhang11Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineAbstract Background Glycemic variability plays an important role in the development of cardiovascular disease (CVD). This study aims to determine whether long-term visit-to-visit glycemic variability is associated with aortic stiffness progression in participants with type 2 diabetes (T2D). Methods Prospective data were obtained from 2115 T2D participants in the National Metabolic Management Center (MMC) from June 2017 to December 2022. Two brachial-ankle pulse wave velocity (ba-PWV) measurements were performed to assess aortic stiffness over a mean follow-up period of 2.6 years. A multivariate latent class growth mixed model was applied to identify trajectories of blood glucose. Logistic regression models were used to determine the odds ratio (OR) for aortic stiffness associated with glycemic variability evaluated by the coefficient of variation (CV), variability independent of the mean (VIM), average real variability (ARV), and successive variation (SV) of blood glucose. Results Four distinct trajectories of glycated hemoglobin (HbA1c) or fasting blood glucose (FBG) were identified. In the U-shape class of HbA1c and FBG, the adjusted ORs were 2.17 and 1.21 for having increased/persistently high ba-PWV, respectively. Additionally, HbA1c variability (CV, VIM, SV) was significantly associated with aortic stiffness progression, with ORs ranging from 1.20 to 1.24. Cross-tabulation analysis indicated that the third tertile of the HbA1c mean and VIM conferred a 78% (95% confidence interval [CI] 1.23–2.58) higher odds of aortic stiffness progression. Sensitivity analysis demonstrated that the SD of HbA1c and the highest HbA1c variability score (HVS) were significantly associated with the adverse outcomes independent of the mean of HbA1c during the follow-up. Conclusions Long-term visit-to-visit HbA1c variability was independently associated with aortic stiffness progression, suggesting that HbA1c variability was a strong predictor of subclinical atherosclerosis in T2D participants.https://doi.org/10.1186/s12933-023-01884-7TrajectoryHbA1c variabilityFBG variabilityType 2 diabetesPulse wave velocityAortic stiffness |
| spellingShingle | Qianhua Fang Juan Shi Jia Zhang Ying Peng Cong Liu Xing Wei Zhuomeng Hu Lin Sun Jie Hong Weiqiong Gu Weiqing Wang Yifei Zhang Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes Cardiovascular Diabetology Trajectory HbA1c variability FBG variability Type 2 diabetes Pulse wave velocity Aortic stiffness |
| title | Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes |
| title_full | Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes |
| title_fullStr | Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes |
| title_full_unstemmed | Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes |
| title_short | Visit-to-visit HbA1c variability is associated with aortic stiffness progression in participants with type 2 diabetes |
| title_sort | visit to visit hba1c variability is associated with aortic stiffness progression in participants with type 2 diabetes |
| topic | Trajectory HbA1c variability FBG variability Type 2 diabetes Pulse wave velocity Aortic stiffness |
| url | https://doi.org/10.1186/s12933-023-01884-7 |
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