Long-Term Glycemic Variability Is Associated With Arterial Stiffness in Chinese Adults

Yuwen Zhang; Shujing Wu; Mian Li; Tiange Wang; Min Xu; Jieli Lu; Shuangyuan Wang; Jie Zhang; Yufang Bi; Weiqing Wang; Guang Ning; Yu Xu; Yuhong Chen

doi:10.3389/fendo.2021.711540

Long-Term Glycemic Variability Is Associated With Arterial Stiffness in Chinese Adults

Front Endocrinol (Lausanne). 2021 Sep 16:12:711540. doi: 10.3389/fendo.2021.711540. eCollection 2021.

Authors

Yuwen Zhang^{1

2}, Shujing Wu^{1

2}, Mian Li^{1

2}, Tiange Wang^{1

2}, Min Xu^{1

2}, Jieli Lu^{1

2}, Shuangyuan Wang^{1

2}, Jie Zhang^{1

2}, Yufang Bi^{1

2}, Weiqing Wang^{1

2}, Guang Ning^{1

2}, Yu Xu^{1

2}, Yuhong Chen^{1

2}

Affiliations

¹ Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

Objective: The aim of the study was to investigate the association between the visit-to-visit variability (VVV) of fasting plasma glucose (FPG) and arterial stiffness in Chinese adults.

Methods: We performed a cohort study involving 2002 Chinese adults with no history of myocardial infarction or stroke. All the participants attended three visits (the baseline visit in 2008, the 2^nd visit in 2009 and the 3^rd visit in 2013). We used four measures to define the VVV of FPG across the three visits: the standard deviation (SD), the coefficient of variation (CV), the average successive variability (ASV) and the variability independent of the mean (VIM). We used brachial-ankle pulse wave velocity (ba-PWV) to measure arterial stiffness at the 2^nd and the 3^rd visits.

Results: Compared with the lowest tertile of all the four measurements of VVV of FPG, significantly increased levels of ba-PWV change, ratio of ba-PWV change and the occurrence of the elevated ba-PWV were found in the highest tertile. The odds ratio (OR) and 95% confidence interval (CI) comparing participants in the highest tertile vs. the lowest tertile of FPG-SD was 1.37 (1.01-1.86) for risks of having elevated ba-PWV, even after adjustment for covariates including the mean FPG. Similar results were found for FPG-CV and FPG-VIM.

Conclusion: Greater long-term variability of FPG was associated with an increased risk of arterial stiffness, suggesting that the VVV of FPG could be used for an early detection of subclinical atherosclerosis.

Keywords: arterial stiffness; brachial-ankle pulse wave velocity; cardiovascular disease; glycemic variability; subclinical atherosclerosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Ankle
Blood Glucose / analysis*
Brachial Artery
China
Cohort Studies
Fasting
Female
Humans
Male
Middle Aged
Odds Ratio
Pulse Wave Analysis
Vascular Stiffness / physiology*

Substances

Blood Glucose