Glucose variability is associated with an adverse vascular profile but only in the presence of insulin resistance in individuals with type 1 diabetes: An observational study.
Glucose variability is associated with an adverse vascular profile but only in the presence of insulin resistance in individuals with type 1 diabetes: An observational study.
复制标题
DOI：
10.1177/14791641221103217
复制
发表时间：
2022-05
影响因子：
2.4
通讯作者：
Campbell, Matthew D.
中科院分区：
文献类型：
--
作者：
Kietsiriroje, Noppadol;Pearson, Sam M.;O'Mahoney, Lauren L.;West, Daniel J.;Ariens, Robert A. S.;Ajjan, Ramzi A.;Campbell, Matthew D.
我们假设，高血糖变异性 (GV) 对 1 型糖尿病患者的不利影响主要在伴有胰岛素抵抗的患者中最为明显。我们使用三项随机对照试验的基线观察数据对连续血糖监测（CGM）进行了二次分析，并评估了与已建立的血管标志物的关系。我们使用标准 CGM 汇总统计数据和主成分分析来生成每个参与者的个体血糖变异特征。然后采用聚类分析来建立三个 GV 聚类（分别为低 GV、中 GV 或高 GV）。然后根据胰岛素抵抗研究与血栓生物标志物的关系，并以估计的葡萄糖处理率（eGDR）进行评估。在 107 名患者中，45%、37% 和 18% 的患者分别被分配到低、中和高 GV 组。所有三个 GV 簇中的血栓形成生物标志物（包括纤维蛋白原、纤溶酶原激活物抑制剂-1、组织因子活性和肿瘤坏死因子-α）均呈逐步增加的趋势；血栓形成标志物的增加在 eGDR 较低但不较高且 eGDR 阈值 <5.1 mg/kg/min 的情况下很明显。较高的 GV 与 1 型糖尿病患者血栓生物标志物增加相关，但仅限于伴有胰岛素抵抗的患者。
We hypothesised that the detrimental effect of high glucose variability (GV) in people with type 1 diabetes is mainly evident in those with concomitant insulin resistance. We conducted secondary analyses on continuous glucose monitoring (CGM) using baseline observational data from three randomised controlled trials and assessed the relationship with established vascular markers. We used standard CGM summary statistics and principal component analysis to generate individual glucose variability signatures for each participant. Cluster analysis was then employed to establish three GV clusters (low, intermediate, or high GV, respectively). The relationship with thrombotic biomarkers was then investigated according to insulin resistance, assessed as estimated glucose disposal rate (eGDR). Of 107 patients, 45%, 37%, and 18% of patients were assigned into low, intermediate, and high GV clusters, respectively. Thrombosis biomarkers (including fibrinogen, plasminogen activator inhibitor-1, tissue factor activity, and tumour necrosis factor-alpha) increased in a stepwise fashion across all three GV clusters; this increase in thrombosis markers was evident in the presence of low but not high eGDR and at a threshold of eGDR <5.1 mg/kg/min. Higher GV is associated with increased thrombotic biomarkers in type 1 diabetes but only in those with concomitant insulin resistance.
登录
查看更多内容
影响因子：
7.7
作者：
Williams, KV;Erbey, JR;Orchard, TJ
通讯作者：
Orchard, TJ
影响因子：
3.5
作者：
Helliwell, Rebecca;Warnes, Harriet;Ajjan, Ramzi A.
通讯作者：
Ajjan, Ramzi A.
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：
16.2
作者：
Lachin JM;Bebu I;Bergenstal RM;Pop-Busui R;Service FJ;Zinman B;Nathan DM;DCCT/EDIC Research Group
通讯作者：
DCCT/EDIC Research Group
影响因子：
5.9
作者：
Suh S;Kim JH
通讯作者：
Kim JH