Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City.
School of Medicine, National Yang-Ming University, Taipei City.
Diab Vasc Dis Res. 2020 Mar-Apr;17(3):1479164120909030. doi: 10.1177/1479164120909030.
Glucose variability is predictive of cardiovascular events and all-cause mortality. However, the association between peripheral artery disease and glucose variability has not been thoroughly investigated. Therefore, the standard deviation of annual haemoglobin A1c was assessed in patients with type 2 diabetes for evaluating the different risks of peripheral artery disease.
A total of 4144 patients underwent an evaluation for the ankle-brachial index and the percentage of mean arterial pressure at the ankle. The first haemoglobin A1c record was retrospectively collected from each year until the ankle-brachial index measurement.
The standard deviation of annual haemoglobin A1c was higher in patients with ankle-brachial index ⩽0.90 than in those with ankle-brachial index >0.90 (1.1 ± 0.9% vs 1.0 ± 0.8%, = 0.009) and was higher in patients with percentage of mean arterial pressure ⩾45% than in those with percentage of mean arterial pressure <45% (1.1 ± 0.8% vs 1.0 ± 0.8%, = 0.007). A high standard deviation and mean of annual haemoglobin A1c are associated with high-risk peripheral artery disease, which is defined as a combination of ankle-brachial index ⩽0.90, percentage of mean arterial pressure ⩾45% or both (odds ratio = 1.306; 95% confidence interval = 1.057-1.615; = 0.014).
Fluctuation in the haemoglobin A1c value indicates higher risk for peripheral artery disease in patients with type 2 diabetes and poor glucose control.
血糖变异性可预测心血管事件和全因死亡率。然而，外周动脉疾病与血糖变异性之间的关系尚未得到充分研究。因此，评估了 2 型糖尿病患者的年度糖化血红蛋白标准差，以评估外周动脉疾病的不同风险。
共有 4144 名患者接受了踝臂指数和踝部平均动脉压百分比的评估。从每年回顾性收集第一个糖化血红蛋白记录，直到进行踝臂指数测量。
踝臂指数 ⩽0.90 的患者的年度糖化血红蛋白标准差高于踝臂指数>0.90 的患者（1.1±0.9%比 1.0±0.8%， = 0.009），且平均动脉压百分比 ⩾45%的患者高于平均动脉压百分比<45%的患者（1.1±0.8%比 1.0±0.8%， = 0.007）。高年度糖化血红蛋白标准差和均值与高危外周动脉疾病相关，高危外周动脉疾病定义为踝臂指数 ⩽0.90、平均动脉压百分比 ⩾45%或两者的组合（比值比=1.306；95%置信区间=1.057-1.615； = 0.014）。
糖化血红蛋白值的波动表明 2 型糖尿病和血糖控制不佳患者的外周动脉疾病风险更高。
