Impact of long-term glucose variability on coronary atherosclerosis progression in patients with type 2 diabetes: a 2.3 year follow-up study.
Impact of long-term glucose variability on coronary atherosclerosis progression in patients with type 2 diabetes: a 2.3 year follow-up study.
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长期血糖变异对 2 型糖尿病患者冠状动脉粥样硬化进展的影响：一项 2.3 年随访研究。
DOI：
10.1186/s12933-020-01126-0
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发表时间：
2020-09-25
影响因子：
9.3
通讯作者：
Chen Y
中科院分区：
文献类型：
--
作者：
Li S;Tang X;Luo Y;Wu B;Huang Z;Li Z;Peng L;Ling Y;Zhu J;Zhong J;Liu J;Chen Y
糖基化变异性（GV）可导致心血管事件的风险。在这项研究中，我们的目的是调查长期GV是否对2型糖尿病（T2 DM）患者的冠状动脉粥样硬化进展有影响。共纳入了396例在基线和随访评价时[中位2.3（1.8-3.1）年]有冠状动脉计算机断层扫描血管造影和实验室数据可用的T2 DM患者。每1-3个月测量一次空腹血糖（FPG），每季度测量一次HbA 1c。计算HbA 1c和FPG的变异系数（CV）作为GV的测量值。通过测量斑块总体积（TPV）的年变化率和进展率来定量评估冠状动脉斑块。显著进展定义为年TPV进展≥ 15%。多变量回归分析用于评估GV对动脉粥样硬化进展的影响。在396例患者中，TPV的年变化为12.35 ± 14.23 mm 3，年进展率为13.36 ± 12.69%。有143例（36.11%）患者发生了显著进展，其CV-HbA 1c（P < 0.001）和CV-FPG（P < 0.001）显著高于无显著进展的患者。在多变量回归分析中，CV-HbA 1c和CV-FPG均为TPV年变化的独立预测因子[CV-HbA 1c：β = 0.241（0.019-0.462），P = 0.034; CV-FPG：β = 0.265（0.060-0.465），P = 0.012]，年TPV进展[CV-HbA 1c：β = 0.214（0.023-0.405），P = 0.029; CV-FPG：β = 0.218（0.037-0.399），P = 0.019]和显著动脉粥样硬化进展[CV-HbA 1c：比值比[OR] = 1.367 CV-FPG：OR = 1.321（1.127-1.634），P = 0.013]。长期GV与T2 DM患者冠状动脉粥样硬化的加速进展相关，与传统危险因素无关。试验注册ClinicalTrials.gov（NCT 02587741），2015年10月27日;回顾性注册
Glycemic variability (GV) confers a risk of cardiovascular events. In this study, we aimed to investigate whether long-term GV has an impact on coronary atherosclerosis progression in patients with type 2 diabetes mellitus (T2DM). A total of 396 patients with T2DM who had coronary computed tomography angiography and laboratory data available at baseline and for follow-up evaluations [median 2.3 (1.8–3.1) years] were included. Fasting plasma glucose (FPG) was measured every 1–3 months, and HbA1c was measured quarterly. The coefficient of variation (CV) of HbA1c and FPG were calculated as measures of GV. Quantitative assessment of coronary plaques was performed by measuring the annual change and progression rate of total plaque volume (TPV). Significant progression was defined as annual TPV progression ≥ 15%. Multivariable regression analyses were used to assess the effects of GV on atherosclerosis progression. In the 396 patients, the annual change in TPV was 12.35 ± 14.23 mm3, and annual progression rate was 13.36 ± 12.69%. There were 143 (36.11%) patients with significant progression, and they had a significantly higher CV-HbA1c (P < 0.001) and CV-FPG (P < 0.001) than those without significant progression. In multivariable regression analyses, both CV-HbA1c and CV-FPG were independent predictors of annual change in TPV [CV-HbA1c: β = 0.241 (0.019–0.462), P = 0.034; CV-FPG: β = 0.265 (0.060–0.465), P = 0.012], annual TPV progression [CV-HbA1c: β = 0.214 (0.023–0.405), P = 0.029; CV-FPG: β = 0.218 (0.037–0.399), P = 0.019], and significant atherosclerosis progression [CV-HbA1c: odds ratio [OR] = 1.367 (1.149–1.650), P = 0.010; CV-FPG: OR = 1.321 (1.127–1.634), P = 0.013]. Long-term GV is associated with accelerated progression of coronary atherosclerosis independent of conventional risk factors in patients with T2DM. Trial registration ClinicalTrials.gov (NCT02587741), October 27, 2015; retrospectively registered
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DOI：
10.3803/enm.2017.32.2.241
发表时间：
2017-06
期刊：
Endocrinology and metabolism (Seoul, Korea)
影响因子：
--
作者：
Kim NH;Kim DL;Kim KJ;Kim NH;Choi KM;Baik SH;Kim SG
通讯作者：
Kim SG
影响因子：
16.2
作者：
Gogitidze Joy N;Hedrington MS;Briscoe VJ;Tate DB;Ertl AC;Davis SN
通讯作者：
Davis SN
影响因子：
9.3
作者：
Besch, Guillaume;Pili-Floury, Sebastien;Chopard, Romain
通讯作者：
Chopard, Romain
影响因子：
2.8
作者：
Bayturan, Ozgur;Tuzcu, E. Murat;Nicholls, Stephen J.
通讯作者：
Nicholls, Stephen J.
影响因子：
11.3
作者：
Kuroda, Masaru;Shinke, Toshiro;Hirata, Ken-ichi
通讯作者：
Hirata, Ken-ichi