Higher HbA1c variability is associated with increased arterial stiffness in individuals with type 1 diabetes(vol 22,47,2023)

被引：0

作者：

Tynjala, Anniina ^{[3
]}

Harjutsalo, Valma ^{[1
,2
,3
,4
]}

Sigfrids, Fanny Jansson ^{[1
,2
,3
,4
]}

Groop, Per-Henrik ^{[1
,2
,3
,4
,6
]}

Gordin, Daniel ^{[2
,3
,5
,7
]}

机构：

[1] Folkhalsan Res Ctr, Folkhalsan Inst Genet, Helsinki, Finland

[2] Univ Helsinki, Dept Nephrol, Helsinki, Finland

[3] Helsinki Univ Hosp, Helsinki, Finland

[4] Univ Helsinki, Fac Med, Res Program Clin & Mol Metab, Helsinki, Finland

[5] Minerva Fdn, Helsinki, Finland

[6] Monash Univ, Cent Clin Sch, Dept Diabet, Melbourne, Australia

[7] Harvard Med Sch, Joslin Diabet Ctr, Boston, MA USA

来源：

CARDIOVASCULAR DIABETOLOGY | 2023年 / 22卷 / 01期

基金：

芬兰科学院;

关键词：

Applanation tonometry; Arterial stiffness; Augmentation index; Cardiovascular disease; Glycaemic variability; HbA[!sub]1c[!/sub; Pulse wave velocity; Type; 1; diabetes;

D O I：

10.1186/s12933-023-01813-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Both long-term glycaemic variability and arterial stiffness have been recognized as cardiovascular risk factors. This study aims to investigate whether an association between these phenomena exists in individuals with type 1 diabetes. Methods: This cross-sectional study included 673 adults (305 men, 368 women) with type 1 diabetes and combined available retrospective laboratory data on HbA1c from the preceding 10 years with outcome data on arterial stiffness and clinical variables from a comprehensive study visit. HbA1c variability was calculated as adjusted standard deviation (adj-HbA1c-SD), coefficient of variation (HbA1c-CV) and average real variability (HbA1c-ARV). As measures of arterial stiffness, carotid-femoral pulse wave velocity (cfPWV; n = 335) and augmentation index (AIx; n = 653) were assessed using applanation tonometry. Results: The study population had a mean age of 47.1 (± 12.0) years and a median duration of diabetes of 31.2 (21.2–41.3) years. The median number of HbA1c assessments per individual was 17 (12–26). All three indices of HbA1c variability were significantly correlated with both cfPWV and AIx after adjustment for sex and age (p < 0.001). In separate multivariable linear regression models, adj-HbA1c-SD and HbA1c-CV were significantly associated with cfPWV (p = 0.032 and p = 0.046, respectively) and AIx (p = 0.028 and p = 0.049, respectively), even after adjustment for HbA1c-mean. HbA1c-ARV was not associated with cfPWV or AIx in the fully adjusted models. Conclusions: An association independent of HbA1c-mean was found between HbA1c variability and arterial stiffness, suggesting a need to consider multiple HbA1c metrics in studies assessing cardiovascular risk in type 1 diabetes. Longitudinal and interventional studies are needed to confirm any causal relationship and to find strategies for reducing long-term glycaemic variability. © 2023, The Author(s).

引用

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