Abstract
ObjectiveThe aim of the study was to investigate the association between the visit-to-visit variability (VVV) of fasting plasma glucose (FPG) and arterial stiffness in Chinese adults.MethodsWe performed a cohort study involving 2002 Chinese adults with no history of myocardial infarction or stroke. All the participants attended three visits (the baseline visit in 2008, the 2nd visit in 2009 and the 3rd visit in 2013). We used four measures to define the VVV of FPG across the three visits: the standard deviation (SD), the coefficient of variation (CV), the average successive variability (ASV) and the variability independent of the mean (VIM). We used brachial-ankle pulse wave velocity (ba-PWV) to measure arterial stiffness at the 2nd and the 3rd visits.ResultsCompared with the lowest tertile of all the four measurements of VVV of FPG, significantly increased levels of ba-PWV change, ratio of ba-PWV change and the occurrence of the elevated ba-PWV were found in the highest tertile. The odds ratio (OR) and 95% confidence interval (CI) comparing participants in the highest tertile vs. the lowest tertile of FPG-SD was 1.37 (1.01-1.86) for risks of having elevated ba-PWV, even after adjustment for covariates including the mean FPG. Similar results were found for FPG-CV and FPG-VIM.ConclusionGreater long-term variability of FPG was associated with an increased risk of arterial stiffness, suggesting that the VVV of FPG could be used for an early detection of subclinical atherosclerosis.
Highlights
Glycemic impairment even within the nondiabetic range has been considered to be an independent risk factor for cardiovascular disease (CVD) [1,2,3,4]
By performing multiple linear regression analysis, we found that fasting plasma glucose (FPG)-SD, FPG-CV, FPG-ASV and FPG-VIM were all independently associated with the brachial-ankle pulse wave velocity (ba-PWV) changes even after full adjustment for covariates in Model 4
In this community-based cohort study, we found that the increased visit-to-visit variability (VVV) of FPG, measured by FPG-SD, FPG-CV, FPGASV and FPG-VIM, was significantly associated with increased arterial stiffness determined by elevated ba-PWV
Summary
Glycemic impairment even within the nondiabetic range has been considered to be an independent risk factor for cardiovascular disease (CVD) [1,2,3,4]. Previous studies investigating the hyperglycemia-related complications have mainly relied on blood glucose assessment at a single point in time, which may not capture the true underlying glucose levels over time, while glycemic variability is recognized recently as a measure that could more accurately capture the pathological processes before the occurrence of complications. Glycemic variability is an assessment of changes in glycemia of both short and long terms. The changes of glycemia in one day or between two days are short-term glycemic variability, which can be evaluated through continuous glucose monitoring (CGM) [5]. If the changes are within months or years, they are regarded as long-term glycemic variability, which can be evaluated through visit-to-visit variability of hemoglobin A1c (HbA1c) or blood glucose [5]. Previous studies on glycemic variability were mainly conducted in people with diabetes and focused on short-term variability [6], the prognostic value of long-term glycemic variability has been understudied in the general population
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