Relationship Between Glycosylated Hemoglobin Variability and the Severity of Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus.

Publisher: Hindawi Limited Country of Publication: England NLM ID: 101605237 Publication Model: eCollection Cited Medium: Internet ISSN: 2314-6753 (Electronic) NLM ISO Abbreviation: J Diabetes Res Subsets: MEDLINE

Publication: <2019>-: London, United Kingdom : Hindawi Limited
Original Publication: Nasr City, Cairo : Hindawi Publishing Corporation, [2013]-

Diabetes Mellitus, Type 2*/complications ; Diabetes Mellitus, Type 2*/blood ; Glycated Hemoglobin*/metabolism ; Glycated Hemoglobin*/analysis ; Coronary Artery Disease*/blood ; Coronary Artery Disease*/epidemiology ; Severity of Illness Index* ; Coronary Angiography*; Humans ; Male ; Female ; Middle Aged ; Aged ; Risk Factors ; Multivariate Analysis

Background: Glycosylated hemoglobin (HbA1c) variability is a risk factor for cardiovascular complications in patients with Type 2 diabetes mellitus (T2DM), but its relationship with the severity of coronary artery disease (CAD) is unclear. Methods: Patients with T2DM who underwent coronary angiography due to angina were enrolled. HbA1c variability was expressed as coefficient of variation (CV), standard deviation (SD), variability independent of mean (VIM), and time in range (TIR). The severity of CAD was expressed by the number of involved vessels and Gensini score. Multivariate regression models were constructed to test the relationship between HbA1c variability, number of involved vessels, and the Gensini score, followed by linear regression analysis. Results : A total of 147 patients were included. In multivariate analysis, VIM-HbA1c (OR = 2.604; IQR: 1.15, 5.90; r = 0.026) and HbA1cTIR (OR = 0.13; IQR: 0.04, 0.41; r < 0.001) were independent risk factors for the number of involved vessels. After adjustment, HbA1cTIR (OR = 0.01; IQR: 0.002, 0.04; r < 0.001), SD-HbA1c (OR = 4.12, IQR: 1.64, 10.35; r = 0.001), CV-HbA1c (OR = 1.41, IQR: 1.04, 1.92; r = 0.007), and VIM-HbA1c (OR = 3.26; IQR: 1.43, 7.47; r = 0.003) were independent risk factors for the Gensini score. In the linear analysis, the Gensini score was negatively correlated with HbA1cTIR ( β = -0.629; r < 0.001) and positively correlated with SD-HbA1c ( β = 0.271; r = 0.001) and CV-HbA1c ( β = 0.176; r = 0.033). After subgroup analysis, HbA1cTIR was a risk factor for the number of involved vessels. The Gensini score was negatively correlated with HbA1cTIR and positively correlated with SD-HbA1c at subgroups of subjects with a mean HbA1c ≤ 7%. Conclusions: Our analysis indicates that HbA1c variability, especially HbA1cTIR, plays a role for the severity of CAD in patients with T2DM. HbA1c variability may provide additional information and require management even at the glycemic target. Translational Aspects: Studies have shown that HbA1c variability is related to cardiovascular complications. Further, we explore the correlation between HbA1c variability and the severity of CAD. HbA1c variability is a risk factor for coronary stenosis in T2DM. It may be a potential indicator reflecting glycemic control for the prevention and treatment of cardiovascular complications.
Competing Interests: The authors declare no conflicts of interest.
(Copyright © 2024 Xinyan Liu et al.)

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Keywords: HbA1c time in range; Type 2 diabetes mellitus; coronary heart disease; diabetic cardiovascular complications; glycosylated hemoglobin variability

0 (Glycated Hemoglobin)
0 (hemoglobin A1c protein, human)

Date Created: 20240809 Date Completed: 20240809 Latest Revision: 20240810

20240812

PMC11309811

10.1155/2024/9958586

39118831