Association of visit-to-visit HbA1c variability with cardiovascular diseases in type 2 diabetes within or outside the target range of HbA1c.
Association of visit-to-visit HbA1c variability with cardiovascular diseases in type 2 diabetes within or outside the target range of HbA1c.
复制标题
HbA1c 目标范围内或之外的 2 型糖尿病患者的每次就诊 HbA1c 变异性与心血管疾病的关联。
DOI：
10.3389/fpubh.2022.1052485
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发表时间：
2022
影响因子：
5.2
通讯作者：
Zhang, Wei
中科院分区：
文献类型：
--
作者：
Sun, Bao;Gao, Yongchao;He, Fazhong;Liu, Zhaoqian;Zhou, Jiecan;Wang, Xingyu;Zhang, Wei
关键词：
虽然最近越来越多的关注HbA 1c变异性在糖尿病并发症风险中的作用，但HbA 1c变异性对2型糖尿病心血管疾病（CVD）的影响仍有争议。本研究旨在研究HbA 1c变异性与HbA 1c目标范围内或目标范围外个体CVD的相关性。使用糖尿病和血管疾病行动：preterAx和diamicroN-MR对照评价（ADVANCE）的数据，我们在中国招募了855例2型糖尿病患者。主要结局包括主要大血管事件和主要微血管事件。访视间HbA 1c变异性表示为治疗后3-24个月进行的5次HbA 1c测量的变异系数（CV）。使用考克斯比例风险模型估计校正的风险比（aHR）。在强化葡萄糖治疗组的855例患者中，563例和292例患者分别被分配到“HbA 1c目标范围内”（WTH）（更新的平均HbA 1c ≤ 7.0%）和“HbA 1c目标范围外”（OTH）（更新的平均HbA 1c> 7.0%）组。在4.8年的中位随访期内，所有患者和两个亚组的HbA 1c变异性与主要微血管事件的风险呈正相关。特别是，WTH组患者新发或恶化肾病的HbA 1c变异性相关风险更高[aHR：3.35; 95%置信区间（CI）：1.05-10.74; P = 0.042]。这项回顾性队列研究证实了HbA 1c变异性与主要微血管事件之间的正相关性，尤其是在WTH或OTH受试者中。
Although a growing attention has been recently paid to the role of HbA1c variability in the risk of diabetic complications, the impact of HbA1c variability on cardiovascular diseases (CVD) in type 2 diabetes is still debated. The aim of the study is to investigate the association of HbA1c variability with CVD in individuals within or outside the target range of HbA1c. Using data from Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation (ADVANCE), we enrolled 855 patients with type 2 diabetes in China. The primary outcomes included major macrovascular events and major microvascular events. Visit-to-visit HbA1c variability was expressed as the coefficient of variation (CV) of five measurements of HbA1c taken 3–24 months after treatment. Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR). Among 855 patients in the intensive glucose treatment group, 563 and 292 patients were assigned to the group of “within the target range of HbA1c” (WTH) (updated mean HbA1c ≤ 7.0%) and “outside the target range of HbA1c” (OTH) (updated mean HbA1c > 7.0%), respectively. HbA1c variability was positively associated with the risk of major microvascular events in all patients and both the subgroups during a median follow-up period of 4.8 years. Particularly, the risk related to HbA1c variability was higher in patients in WTH group for the new or worsening nephropathy [aHR: 3.35; 95% confidence interval (CI): 1.05–10.74; P = 0.042]. This retrospective cohort study confirmed the positive correlation between HbA1c variability and major microvascular events, especially in subjects in WTH or OTH.
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影响因子：
16.2
作者：
Danne T;Nimri R;Battelino T;Bergenstal RM;Close KL;DeVries JH;Garg S;Heinemann L;Hirsch I;Amiel SA;Beck R;Bosi E;Buckingham B;Cobelli C;Dassau E;Doyle FJ 3rd;Heller S;Hovorka R;Jia W;Jones T;Kordonouri O;Kovatchev B;Kowalski A;Laffel L;Maahs D;Murphy HR;Nørgaard K;Parkin CG;Renard E;Saboo B;Scharf M;Tamborlane WV;Weinzimer SA;Phillip M
通讯作者：
Phillip M
影响因子：
16.2
作者：
通讯作者：
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影响因子：
4.1
作者：
Gu, Jun;Fan, Yu-Qi;Wang, Chang-Qian
通讯作者：
Wang, Chang-Qian
影响因子：
9.3
作者：
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通讯作者：
Nicolucci A
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影响因子：
11.1
作者：
He F;Liu M;Chen Z;Liu G;Wang Z;Liu R;Luo J;Tang J;Wang X;Liu X;Zhou H;Chen X;Liu Z;Zhang W
通讯作者：
Zhang W