Department of Internal Medicine, Chungju Medical Center, Chungju-si, South Korea.
Department of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, South Korea.
Sci Rep. 2019 Feb 4;9(1):1374. doi: 10.1038/s41598-018-37834-7.
This study evaluate association between glycemic variability and adverse vascular events in nondiabetic middle-aged adults. From 10,020 Ansung-Ansan cohort, Korean Genome, and Epidemiology Study (KoGES) data. 6,462 nondiabetic adults aged <65 years was analyzed. The mean and coefficient of variation (CV) of all biannually recorded HbA1c, fasting blood glucose(FBG), and post 2 hr blood glucose (PBG) were calculated and divided into 3 groups based on tertile of CV at each measurement, respectively. Primary endpoint was composite of Macro (composite of Coronary artery disease, Myocardial infarction, Congestive heart failure or Stroke) and Microvascular event (Creatine Clearance <60 ml/min/1.73 m). The participants (mean age: 50 years, 50% men) were followed for a median of 9.9 (9.1-10.0) years. The high HbA1c-CV tertile (odds ratio 1.30; 1.01-1.66) was independent risk factor for microvascular events. In contrast, high FBG-CV tertile (2.32; 1.30-4.12) and PBG-CV (1.85; 1.05-3.26) was for macrovascular events. In this 10-year prespective cohort study, higher HbA1c-CV tertile was associated with higher composite of macro- and microvascular events and independent risk factor in non-DM middle-aged participants. In addition, higher tertile of FBG-CV and PBG-CV were risk factors for macrovascular events.
本研究评估了非糖尿病中年成年人血糖变异性与不良血管事件之间的关联。该研究来自韩国基因组与流行病学研究（KoGES）的 Ansung-Ansan 队列和 10020 名数据。分析了 6462 名年龄<65 岁的非糖尿病成年人。根据每个测量的 CV 三分位数，计算并将所有每两年记录一次的 HbA1c、空腹血糖（FBG）和餐后 2 小时血糖（PBG）的平均值和变异系数（CV）分为 3 组。主要终点是宏观终点（复合终点为冠状动脉疾病、心肌梗死、充血性心力衰竭或中风）和微血管终点（肌酸清除率<60 ml/min/1.73 m）。参与者（平均年龄：50 岁，50%为男性）的中位随访时间为 9.9 年（9.1-10.0）。高 HbA1c-CV 三分位数（比值比 1.30；1.01-1.66）是微血管事件的独立危险因素。相比之下，高 FBG-CV 三分位数（2.32；1.30-4.12）和 PBG-CV（1.85；1.05-3.26）与大血管事件相关。在这项为期 10 年的前瞻性队列研究中，较高的 HbA1c-CV 三分位数与非糖尿病中年参与者的大血管和微血管复合事件的发生相关，是独立的危险因素。此外，较高的 FBG-CV 和 PBG-CV 三分位数是大血管事件的危险因素。
