Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, United States.
Front Endocrinol (Lausanne). 2024 Nov 7;15:1383345. doi: 10.3389/fendo.2024.1383345. eCollection 2024.
Glycemic variability is a novel predictor for diabetic complications. Different studies have demonstrated contradictory results for the association between HbA1c variability and diabetic retinopathy. We aimed to assess the relationship between visit-to-visit variability in glycemic profile (HbA1c, 2hPP, and FBS) and diabetic retinopathy.
Patients with type 2 diabetes were monitored for the development of retinopathy for 10 years. The association between the incidence of retinopathy and glycemic variability was assessed via Cox regression analysis, and coefficient of variation for glycemic indices was compared using independent sample -test.
Patients with diabetic retinopathy had significantly higher glycemic profile variability. The incidence of retinopathy was positively correlated with cv-FBS10% (10% of coefficient of variance), cv-FBS20%, cv-2hpp10%, and cv-HbA1c5%. Our analysis revealed that the higher variability of FBS increased the incidence and progression of retinopathy (HR: 12.29, -value = 0.003).
Our findings demonstrated glycemic profile variability as an independent risk factor for diabetic retinopathy in patients with type 2 diabetes and support glycemic profile variability measurement in addition to common glycemic parameters to improve risk stratification in patients with type 2 diabetes. Further investigation is required to demonstrate the long-term effects of alleviating glycemic variability on the prognosis of patients with type 2 diabetes.
血糖变异性是糖尿病并发症的一个新的预测指标。不同的研究表明，HbA1c 变异与糖尿病视网膜病变之间的关系存在矛盾的结果。我们旨在评估血糖谱（HbA1c、2hPP 和 FBS）的日内波动与糖尿病视网膜病变之间的关系。
对 2 型糖尿病患者进行了 10 年的视网膜病变发展监测。通过 Cox 回归分析评估了视网膜病变的发生与血糖变异性之间的关系，并使用独立样本 t 检验比较了血糖指数的变异系数。
患有糖尿病视网膜病变的患者血糖谱的变异性明显更高。视网膜病变的发生率与 cv-FBS10%（变异系数的 10%）、cv-FBS20%、cv-2hpp10%和 cv-HbA1c5%呈正相关。我们的分析表明，FBS 的变异性增加会增加视网膜病变的发生率和进展（HR：12.29，-值=0.003）。
我们的研究结果表明，血糖谱变异性是 2 型糖尿病患者糖尿病视网膜病变的一个独立危险因素，并支持在常规血糖参数之外测量血糖谱变异性，以改善 2 型糖尿病患者的风险分层。需要进一步研究来证明减轻血糖变异性对 2 型糖尿病患者预后的长期影响。
