Alatawi Zinab, Mirghani Hyder
Family Medicine, University of Tabuk, College of Medicine, Tabuk, SAU.
Internal Medicine, University of Tabuk, Tabuk, SAU.
Cureus. 2020 Nov 18;12(11):e11556. doi: 10.7759/cureus.11556.
Diabetes mellitus is a major risk factor for vascular complications and mortality, glycemic variability (GV) has emerged as a measure of time and magnitude of plasma glucose, its association with cardiovascular complications is controversial. The current study aimed to assess the association of GV with myocardial infarction. An electronic literature search was conducted in PubMed, Medline, and Google Scholar databases for relevant articles. Articles in the English language during the period from 2010 to April 2020 were eligible. The keywords fasting blood glucose variability (FBGV), glucose variability, myocardial infarction, and acute coronary syndrome, were used with the protean OR and AND. Out of the 185 articles retrieved, only seven full texts fulfilled the inclusion and exclusion criteria. The author's name, year of publication, the study type, number of patients, and the results were extracted. There were seven full texts, one from Brazil, one from Australia, two from the USA, and three from Asia. Two were randomized controlled trials and five were prospective cohorts (included 109,058 participants). A significant negative association was found between GV and myocardial infarction, odd ratio (OD) 1.93, 95% CI=1.08-3.44, P-value=0.03, I for heterogeneity=87%, P-value=0.0001. However, it is difficult to reach a conclusion due to the small number of the included studies and the high heterogeneity observed. Further well-controlled trials using the same methods are needed to resolve the issue.
糖尿病是血管并发症和死亡的主要危险因素，血糖变异性（GV）已成为衡量血浆葡萄糖时间和幅度的指标，其与心血管并发症的关联存在争议。本研究旨在评估GV与心肌梗死的关联。在PubMed、Medline和谷歌学术数据库中进行了电子文献检索以查找相关文章。2010年至2020年4月期间的英文文章符合要求。使用“空腹血糖变异性（FBGV）”“血糖变异性”“心肌梗死”和“急性冠状动脉综合征”等关键词，并结合多变的“或”和“与”逻辑关系进行检索。在检索到的185篇文章中，只有7篇全文符合纳入和排除标准。提取了作者姓名、发表年份、研究类型、患者数量和结果。有7篇全文，1篇来自巴西，1篇来自澳大利亚，2篇来自美国，3篇来自亚洲。2篇为随机对照试验，5篇为前瞻性队列研究（包括109,058名参与者）。发现GV与心肌梗死之间存在显著的负相关，比值比（OR）为1.93，95%置信区间=1.08 - 3.44，P值=0.03，异质性I²=87%，P值=0.0001。然而，由于纳入研究数量较少且观察到的异质性较高，难以得出结论。需要进一步采用相同方法进行严格对照试验来解决该问题。
