Visit-to-Visit HbA1c Variability Is Associated With Cardiovascular Disease and Microvascular Complications in Patients With Newly Diagnosed Type 2 Diabetes
Visit-to-Visit HbA1c Variability Is Associated With Cardiovascular Disease and Microvascular Complications in Patients With Newly Diagnosed Type 2 Diabetes
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DOI：
10.2337/dc19-0823
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发表时间：
2020-02-01
期刊：
影响因子：
16.2
通讯作者：
Pearson, Ewan R.
中科院分区：
文献类型：
--
作者：
Li, Sheyu;Nemeth, Imola;Pearson, Ewan R.
目的探讨初诊2型糖尿病患者就诊时HbA（1c）变异性与心血管事件和微血管并发症的关系。研究设计和方法本回顾性队列研究分析了苏格兰护理信息-糖尿病协作（SCI-DC）中来自Tayside和Fife的患者，这些患者从糖尿病诊断中可观察到，并且在评估结果之前至少有5次HbA（1c）测量。我们使用了先前报道的HbA（1c）变异性评分（HVS），该评分计算为HbA（1c）在个体内所有HbA（1c）测量值中变化次数的百分比（0.5% (5.5 mmol/mol)）。使用Cox比例风险模型评估HVS与10个结局之间的关系。结果：我们纳入了13,111-19,883例患者，对每个结果进行分析。与最低五分位数（例如，HVS >80 ~ = 0 ~）的患者相比，HVS >60 ~ 60%的患者所有结局的风险均升高
OBJECTIVE To investigate the association between visit-to-visit HbA(1c) variability and cardiovascular events and microvascular complications in patients with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS This retrospective cohort study analyzed patients from Tayside and Fife in the Scottish Care Information-Diabetes Collaboration (SCI-DC) who were observable from the diagnosis of diabetes and had at least five HbA(1c) measurements before the outcomes were evaluated. We used the previously reported HbA(1c) variability score (HVS), calculated as the percentage of the number of changes in HbA(1c) >0.5% (5.5 mmol/mol) among all HbA(1c) measurements within an individual. The association between HVS and 10 outcomes was assessed using Cox proportional hazards models. RESULTS We included 13,111-19,883 patients in the analyses of each outcome. The patients with HVS >60% were associated with elevated risks of all outcomes compared with the lowest quintile (for example, HVS >80 to = 0 to