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The Scope of HbA1c Variability and Risk of Vascular Complications Among Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Studies
被引:10
作者:
Guo, Kai
[1
]
Zhao, Qian
[2
]
Wang, Meng
[3
]
Lu, Yuchun
[3
]
Wo, Meihong
[3
]
Zhou, Xiaoyan
[4
]
Ying, Changjiang
[5
]
机构:
[1] Xuzhou Med Univ, Peoples Hosp Xuzhou 1, Dept Intens Care Unit, Xuzhou Municipal Hosp, Xuzhou, Jiangsu, Peoples R China
[2] Nanjing Univ Chinese Med, Dept Endocrinol, Huaian Tradit Chinese Med Hosp, Huaian, Jiangsu, Peoples R China
[3] Xuzhou Med Univ, Grad Sch, Xuzhou, Jiangsu, Peoples R China
[4] Xuzhou Med Univ, Sch Basic Med, Xuzhou, Jiangsu, Peoples R China
[5] Xuzhou Med Univ, Dept Endocrinol, Affiliated Hosp, 99 West Huai Hai Rd, Xuzhou 211002, Jiangsu, Peoples R China
基金:
中国博士后科学基金;
关键词:
HbA1c variability;
type;
2;
diabetes;
vascular complications;
meta-analysis;
ALL-CAUSE MORTALITY;
GLYCEMIC VARIABILITY;
HBA(1C) VARIABILITY;
ASSOCIATION;
FREQUENCY;
OUTCOMES;
D O I:
10.1055/a-1730-4904
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Glycated hemoglobin (HbA1c) variability is emerging as an indicator of long-term glycemic control, which may play a significant role during vascular complications. We conducted a systematic review and meta-analysis to assess the association between the scope of HbA1c variability and vascular complications in patients with type 2 diabetes mellitus. PubMed and Embase were searched for studies that evaluated the association of HbA1c variability with vascular complications in patients with type 2 diabetes. Two reviewers independently completed data extraction. Random-effects meta-analysis was conducted with stratification according to the type of vascular complications. Nine studies were eligible for inclusion in our systematic review and meta-analysis. Six studies evaluated the impact of the standard deviation of HbA1c (HbA1c-SD) on cardiovascular events and showed an association of HbA1c-SD with cardiovascular events (HR: 1.25, 95% CI 1.18-1.32, 5 studies). Six studies evaluated renal disease associated with HbA1c-SD and showed that HbA1c-SD was correlated with an increased risk of renal disease (HR: 1.19, 95% CI 1.13-1.24). Two studies evaluated HbA1c-SD and the risk of retinopathy and showed that no significant association was found between retinopathy and HbA1c-SD (HR 1.08, 95% CI 0.92-125). For HbA1c-SD ranging from 0.6 to 0.8%, HbA1c-SD was associated with an increased risk of cardiovascular events (HR: 1.25, 95% CI 1.15-1.35) and renal disease (HR: 1.16, 95% CI 1.11-1.22). For individuals with index HbA1c variability greater than or equal to 0.6%, HbA1c variability was significantly associated with vascular complications in patients with type 2 diabetes mellitus.
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页码:94 / 103
页数:10
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