PMID- 38419951
OWN - NLM
STAT- MEDLINE
DCOM- 20240301
LR  - 20240306
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 15
DP  - 2024
TI  - Glycemic variability evaluated by HbA1c rather than fasting plasma glucose is 
      associated with adverse cardiovascular events.
PG  - 1323571
LID - 10.3389/fendo.2024.1323571 [doi]
LID - 1323571
AB  - BACKGROUND: Although studies have shown that glycemic variability is positively 
      associated with an increased risk of cardiovascular disease, few studies have 
      compared hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) variability with 
      adverse cardiovascular events in patients with type 2 diabetes mellitus (T2DM). 
      METHODS: This was a post hoc analysis of the Action to Control Cardiovascular 
      Risk in Diabetes (ACCORD) study. Cox proportional hazards models were used to 
      explore the relationship between HbA1c or FPG variability and the incidence of 
      major adverse cardiovascular events (MACEs). RESULTS: In total, 9,547 patients 
      with T2DM were enrolled in this study. During the median 4.6 +/- 1.5 years 
      follow-up period, 907 patients developed MACEs. The risk of MACEs increased in 
      the HbA1c variability group in each higher quartile of HbA1c variability (P < 
      0.01). Compared with those in the first quartile of HbA1c variability, patients 
      in the fourth quartile had a hazard ratio of 1.37 (Model 2, 95% confidence 
      interval: 1.13-1.67) for MACEs. Higher FPG variability was not associated with a 
      higher risk of MACEs in patients with T2DM (P for trend=0.28). A U-shaped 
      relationship was observed between HbA1c and FPG variability, and MACEs. Glucose 
      control therapy modified the relationship between HbA1c and MACEs; participants 
      with higher HbA1c variability receiving intensive glucose control were more 
      likely to develop MACEs (P for interaction <0.01). CONCLUSION: In adults with 
      T2DM, the relationship between glycemic variability evaluated using HbA1c and FPG 
      was U-shaped, and an increase in HbA1c variability rather than FPG variability 
      was significantly associated with MACEs. The relationship between HbA1c 
      variability and MACEs was affected by the glucose control strategy, and a higher 
      HbA1c variability was more strongly associated with MACEs in patients receiving 
      an intensive glucose control strategy.
CI  - Copyright (c) 2024 Sheng, Yang, Chai, Zhou, Sun and Xing.
FAU - Sheng, Lijuan
AU  - Sheng L
AD  - Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central 
      South University, Changsha, China.
FAU - Yang, Guifang
AU  - Yang G
AD  - Department of Emergency Medicine, Second Xiangya Hospital, Central South 
      University, Changsha, China.
AD  - Trauma Center, Second Xiangya Hospital, Central South University, Changsha, 
      China.
AD  - Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Chai, Xiangping
AU  - Chai X
AD  - Department of Emergency Medicine, Second Xiangya Hospital, Central South 
      University, Changsha, China.
AD  - Trauma Center, Second Xiangya Hospital, Central South University, Changsha, 
      China.
AD  - Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Zhou, Yang
AU  - Zhou Y
AD  - Department of Emergency Medicine, Second Xiangya Hospital, Central South 
      University, Changsha, China.
AD  - Trauma Center, Second Xiangya Hospital, Central South University, Changsha, 
      China.
AD  - Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, 
      Central South University, Changsha, China.
FAU - Sun, Xin
AU  - Sun X
AD  - College of nursing, Changsha Medical University, Changsha, China.
FAU - Xing, Zhenhua
AU  - Xing Z
AD  - Department of Emergency Medicine, Second Xiangya Hospital, Central South 
      University, Changsha, China.
AD  - Trauma Center, Second Xiangya Hospital, Central South University, Changsha, 
      China.
AD  - Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, 
      Central South University, Changsha, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20240214
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Glycated Hemoglobin
MH  - *Diabetes Mellitus, Type 2/epidemiology
MH  - Blood Glucose
MH  - Fasting
MH  - *Cardiovascular Diseases/etiology/complications
PMC - PMC10899469
OTO - NOTNLM
OT  - HbA1c variability
OT  - MACEs
OT  - fasting plasma glucose variability
OT  - glycemic variability
OT  - type 2 diabetes mellitus
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/02/29 06:42
MHDA- 2024/03/01 06:44
PMCR- 2024/01/01
CRDT- 2024/02/29 04:02
PHST- 2023/10/18 00:00 [received]
PHST- 2024/01/24 00:00 [accepted]
PHST- 2024/03/01 06:44 [medline]
PHST- 2024/02/29 06:42 [pubmed]
PHST- 2024/02/29 04:02 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2024.1323571 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2024 Feb 14;15:1323571. doi: 
      10.3389/fendo.2024.1323571. eCollection 2024.