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Association Between Visit-To-Visit Variability of Glycemic Indices and Lipid Profile and the Incidence of Coronary Heart Disease in Adults With Type 2 Diabetes Publisher



Moosaie F1 ; Mouodi M1 ; Sheikhy A1 ; Fallahzadeh A1 ; Deravi N2 ; Rabizadeh S1 ; Fatemi Abhari SM3 ; Meysamie A4 ; Dehghani Firouzabadi F1 ; Nakhjavani M1 ; Esteghamati A1
Authors
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Authors Affiliations
  1. 1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, P.O. Box: 13145-784, Tehran, Iran
  2. 2. Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pediatrics, Imam Ali Hospital, Alborz University of Medical Sciences, Karaj, Iran
  4. 4. Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Diabetes and Metabolic Disorders Published:2021


Abstract

Coronary heart disease (CHD) is one of the major causes of mortality and morbidity in patients with type 2 diabetes mellitus. In this study, we aimed to assess the association between visit-to-visit variability of fasting blood sugar (FBS), HbA1c, blood sugar 2 h post-prandial (BS2hpp), lipid indices, creatinine, systolic and diastolic blood pressure (SBP, DBP) and incident CHD in patients with type 2 diabetes during a median follow-up of ten years. The current case-cohort study consisted of 1500 individuals with type 2 diabetes, followed up for the occurrence of CHD from 2002 to 2019. The patients had at least four annual follow-ups during which glycemic and lipid profile were measured. Co-efficient of variance (CV) for each parameter was calculated by 10-21 measurements. Cox regression analysis was performed to assess the association between CV of glycemic indices, lipid profile, blood pressure, creatinine, weight and incident CHD during the follow-up period. Hazard ratios (HR) were adjusted for the confounding variables. Glycemic indices variability (i.e., CV-HbA1c, CV-FBS, and CV-BS2hpp), were significantly higher in the group with incident CHD (P=0.034, P=0.042, and P=0.044, respectively). Hazard ratios were 1.42 (95 % CI=1.13-2.09) for CV-HbA1c, 1.37 (95 % CI=1.02-2.10) for CV-FBS, and 1.16 (95 % CI=1.01-1.63) for CV-BS2hpp (P=0.012, P=0.046, P=0.038, respectively). Creatinine was significantly higher in the group with incident CHD (P=0.036) and it was significantly associated with higher incidence of CHD (HR=1.14, 95 % CI=1.02-2.17, P=0.048). Visit to visit variability of glycemic indices of the patients with type 2 diabetes is associated with incident CHD independent of their baseline and mean values. © 2021, Springer Nature Switzerland AG.
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