Impact of Visit-to-Visit Fasting Plasma Glucose Variability on the Development of Type 2 Diabetes: A Nationwide Population-Based Cohort Study

Kim, Jung A; Lee, Ji Sung; Chung, Haegeun; Roh, Eun; Lee, You-Bin; Hong, So Hyeon; Kim, Nam Hoon; Yoo, Hye Jin; Seo, Ji A; Kim, Sin Gon; Baik, Sei Hyun; Choi, Kyung Mook

doi:10.2337/dc18-0802

Cited by 48 publications

(60 citation statements)

References 30 publications

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“…The meaning of increased GGT variability is not yet clear. Several recent publications have considered the role of fluctuations in blood glucose, blood pressure, lipid, and body weight on the development of diabetes, CVD, and early death regardless of baseline variables 13,37 . Some basic research data indicate that fluctuations in blood glucose and blood pressure can increase oxidative stress more than continuous hyperglycemia or hypertension 38,39 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of long-term gamma-glutamyl transferase variability in individuals with diabetes: a nationwide population-based study

Lee

Han

et al. 2020

Sci Rep

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We examined whether long-term gamma-glutamyl transferase (GGT) variability can predict cardiovascular disease (CVD) and mortality in individuals with diabetes. We included 698,937 Koreans diabetes patients older than 40 years without histories of CVD, chronic liver disease, or heavy alcoholics who received health exams supported by the Korean government more than once in 2009–2012 (baseline). We used Cox proportional analyses to estimate the risk of stroke, myocardial infarction (MI), and all-cause mortality until December 31, 2016, according to the quartiles of the average successive variability (ASV) of GGT measured during the five years before the baseline. A total 26,119, 15,103, and 39,982 cases of stroke, MI, and death, respectively, were found. GGT ASV quartile 4 had a significantly higher risk of stroke and all-cause mortality than quartile 1, with adjustment for risk factors, such as baseline glucose and GGT level, and comorbidities. Hazard ratios (95% confidence intervals) for GGT ASV quartile 4 were 1.06 (1.03–1.10) and 1.23 (1.20–1.27) for stroke and mortality, respectively. This significant association was shown consistently across the baseline GGT quartiles. GGT variability was related to the risk of stroke and all-cause mortality. The effect was most pronounced in all-cause mortality, irrespective of baseline GGT level.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of long-term gamma-glutamyl transferase variability in individuals with diabetes: a nationwide population-based study

Lee

Han

et al. 2020

Sci Rep

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“…Few previous studies have investigated the prognostic significance of glucose variability in individuals without diabetes. Recently, visit-to-visit fasting glucose variability has been reported as a risk factor for the development of type 2 diabetes [80]. We recently showed that high variability of FBG was an independent predictor of mortality and CV events among the general population [68].…”

Section: Glucose Variabilitymentioning

confidence: 91%

“…Visit-to-visit variability in FBG and HbA1c was associated with the risks of microvascular and macrovascular events and all-cause mortality among patients with type 2 diabetes using data from the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial [80]. Variability in FBG over the course of >7.5 years of follow-up was a potent predictor of ischemic stroke in 28,534 patients with type 2 diabetes in the Taiwan Diabetes Study [81].…”

Section: Glucose Variabilitymentioning

confidence: 99%

Effects of Cardiovascular Risk Factor Variability on Health Outcomes

2020

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Innumerable studies have suggested "the lower, the better" for cardiovascular risk factors, such as body weight, lipid profile, blood pressure, and blood glucose, in terms of health outcomes. However, excessively low levels of these parameters cause health problems, as seen in cachexia, hypoglycemia, and hypotension. Body weight fluctuation is related to mortality, diabetes, obesity, cardiovascular disease, and cancer, although contradictory findings have been reported. High lipid variability is associated with increased mortality and elevated risks of cardiovascular disease, diabetes, end-stage renal disease, and dementia. High blood pressure variability is associated with increased mortality, myocardial infarction, hospitalization, and dementia, which may be caused by hypotension. Furthermore, high glucose variability, which can be measured by continuous glucose monitoring systems or self-monitoring of blood glucose levels, is associated with increased mortality, microvascular and macrovascular complications of diabetes, and hypoglycemic events, leading to hospitalization. Variability in metabolic parameters could be affected by medications, such as statins, antihypertensives, and hypoglycemic agents, and changes in lifestyle patterns. However, other mechanisms modify the relationships between biological variability and various health outcomes. In this study, we review recent evidence regarding the role of variability in metabolic parameters and discuss the clinical implications of these findings.

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“…The study was performed on 234,427 subjects, all of whom were tested for COVID-19 with diagnosis codes of B342, B972, Z208, Z290, U18, U181, Z038, Z115, U071, and U072. The main study [14,15] or heart failure (I11.0, I13.0, I13.2, I50.0, I50.1, I50.9) [16] with at least one annual claim for prescription of an antihypertensive drug. A total of 62,909 subjects aged ≥ 19 years were analyzed.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

Seo

Son

2021

Korean J Intern Med

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Background/Aims Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been concerns about the association between exposure to renin-angiotensin-aldosterone system (RAAS) inhibitors and the risk and severity of COVID-19. Methods We performed a case-control study that utilized up-to-date data on the South Korean population provided by the Korean National Health Insurance System. Of the 62,909 patients with hypertension or heart failure tested for COVID-19, there were 1,644 (2.6%) confirmed cases. After case-control matching, multivariable-adjusted conditional logistic regression analysis was performed. Results Comparison between patients exposed to RAAS inhibitors and those not exposed to RAAS inhibitors revealed that the adjusted odds ratio (OR) and 95% confidence interval (95% CI) for COVID-19 infection and death were 0.981 (0.849-1.135) and 0.875 (0.548-1.396), respectively. Subgroup analysis for the major confounders, age and region of diagnosis, resulted in OR and 95% CI of 0.912 (0.751-1.108) and 0.942 (0.791-1.121), respectively. Conclusions The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

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Impact of Visit-to-Visit Fasting Plasma Glucose Variability on the Development of Type 2 Diabetes: A Nationwide Population-Based Cohort Study

Cited by 48 publications

References 30 publications

Prognostic value of long-term gamma-glutamyl transferase variability in individuals with diabetes: a nationwide population-based study

Prognostic value of long-term gamma-glutamyl transferase variability in individuals with diabetes: a nationwide population-based study

Effects of Cardiovascular Risk Factor Variability on Health Outcomes

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

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