Journal
CARDIOVASCULAR DIABETOLOGY
Volume 18, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12933-019-0854-9
Keywords
Type 2 diabetes; Fasting plasma glucose; Glucose variability; Echocardiography; Cardiac structure
Funding
- National Key R&D Program of China [2017YFA0105803]
- General Program of National Natural Science Foundation of China [81770826]
- 5010 Clinical Research Projects of Sun Yat-sen University [2015015]
- Science and Technology Plan Projects of Guangdong Province [2016A050502010]
- Key Special Projects of Medical and Health Collaborative Innovation of Guangzhou City [201604020016]
- Special Scientific Research Project of Guangzhou City [2060404]
- Science and Technology Plan Project of Guangzhou [201802010048]
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Background: To investigate the effect of visit-to-visit fasting plasma glucose (FPG) variability on the left cardiac structure and function in patients with type 2 diabetes mellitus (T2DM). Methods: In this prospective cohort study, 455 T2DM patients were included and follow-up for a median of 4.7 years. FPG measured on every hospital visit was collected. FPG variability was calculated by its coefficient of variation (CV-FPG). Left cardiac structure and function were assessed using echocardiography at baseline and after follow-up. Multivariable linear regression analyses were used to estimate the effect of FPG variability on the annualized changes in left cardiac structure and function. Subgroup analysis stratified by mean HbA1c levels (<7% and >= 7%) were also performed. Result: In multivariable regression analyses, CV-FPG was independently associated with the annualized changes in left ventricle (beta = 0.137; P = 0.031), interventricularseptum (beta = 0.215; P = 0.001), left ventricular posterior wall thickness (beta = 0.129; P = 0.048), left ventricular mass index (beta = 0.227; P < 0.001), and left ventricular ejection fraction (beta = -0.132; P = 0.030). After additionally stratified by mean HbA1c levels, CV-FPG was still independently associated with the annualized changes in the above parameters in patients with HbA1c >= 7%, while not in patients with HbA1c <7%. Conclusions: Visit-to-visit variability in FPG could be a novel risk factor for the long-term adverse changes in left cardiac structure and systolic function in patients with type 2 diabetes.
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