Association Between Fasting Glucose Variability in Young Adulthood and the Progression of Coronary Artery Calcification in Middle Age
Association Between Fasting Glucose Variability in Young Adulthood and the Progression of Coronary Artery Calcification in Middle Age
复制标题
青年期空腹血糖变异与中年冠状动脉钙化进展之间的关系
DOI：
10.2337/dc20-0838
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发表时间：
2020-10-01
期刊：
影响因子：
16.2
通讯作者：
Chen, Minsheng
中科院分区：
文献类型：
--
作者：
Feng, Weijing;Li, Zhibin;Chen, Minsheng
目的探讨青年期空腹血糖（FG）的个体内变异性是否与中年期冠状动脉钙化（CAC）进展相关。研究设计和方法我们纳入了2，256名年轻人冠状动脉风险发展研究（CARDIA）参与者，在基线（2000-2001）和10年后（2010-2011）通过计算机断层扫描仪进行CAC评估。每个个体的CAC进展评估为随访和基线时CAC评分的对数差值（log[CAC（随访）+1] − log[CAC（基线）+1]）。FG变异性定义为10年随访期间平均FG（FG-CV）、FG标准差（FG-SD）和FG平均真实的变异性（FG-ARV）的变异系数。我们研究了FG变异性与CAC进展之间的相关性，并对人口统计学、临床危险因素、平均FG水平、FG水平变化、糖尿病发病率和药物使用进行了调整。多变量校正后，FG-CV的1-SD增量与CAC恶化进展相关，表现为CAC的百分比变化，10年内发生CAC 5.9%（95%CI 1.0，10.7）和任何CAC进展6.7%（95%CI 2.3，11.1）。在FG-SD和FG-ARV中也观察到类似的结果。结论：青年期较高的FG变异性与中年期较高的CAC进展相关，提示其在预测亚临床冠状动脉疾病风险方面的价值。
OBJECTIVE To investigate whether intraindividual variability of fasting glucose (FG) in young adulthood is associated with coronary artery calcification (CAC) progression in middle age. RESEARCH DESIGN AND METHODS We included 2,256 CARDIA (Coronary Artery Risk Development Study in Young Adults) participants with CAC assessment by computed tomography scanner at baseline (2000–2001) and 10 years later (2010–2011). CAC progression was assessed for each individual as the difference of logarithmic CAC scores at follow-up and baseline (log[CAC (follow-up) + 1] − log[CAC (baseline) + 1]). FG variability was defined by the coefficient of variation about the mean FG (FG-CV), the SD of FG (FG-SD), and the average real variability of FG (FG-ARV) during the 10-year follow-up. We investigated the association between FG variability and CAC progression with adjustment for demographics, clinical risk factors, mean FG level, change in FG level, diabetes incidence, and medication use. RESULTS After multivariable adjustment, 1-SD increment in FG-CV was associated with worse progression of CAC as demonstrated as percent change in CAC, with incident CAC 5.9% (95% CI 1.0, 10.7) and any CAC progression 6.7% (95% CI 2.3, 11.1) during 10 years. Similar findings were also observed in FG-SD and FG-ARV. CONCLUSIONS Higher FG variability during young adulthood was associated with greater CAC progression in middle age, suggesting its value in predicting risk for subclinical coronary artery diseases.