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.
引用
收藏
页码:94 / 103
页数:10
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