Visit-to-visit fasting blood glucose variability and lifetime risk of cardiovascular disease: a prospective study

Abstract

Aims Previous studies suggested an adverse association between higher fasting blood glucose (FBG) variability and cardiovascular disease (CVD). Lifetime risk provides an absolute risk assessment during the remainder of an individual’s life. However, the association between FBG variability and the lifetime risk of CVD is uncertain. Objective We aimed to investigate the effect of the visit-to-visit FBG variability on the lifetime risk of CVD. Methods This study included participants from the Kailuan Study who did not have CVD at index ages 35, 45, and 55 years. The FBG variability was defined as the coefficient of variation (CV) of three FBG values that were measured during the examination periods of 2006–2007, 2008–2009, and 2010–2011. We used a modified Kaplan-Merrier method to estimate lifetime risk of CVD according to tertiles of FBG variability. Results At index age 35 years, the study sample comprised 46,018 participants. During a median follow-up of 7.0 years, 1889 participants developed CVD events. For index age 35 years, participants with high FBG variability had higher lifetime risk of CVD (32.5%; 95% confidence interval [CI]: 28.9–36.1%), compared with intermediate (28.3%; 95% CI: 25.5 –31.1%) and low (26.3%; 95% CI: 23.0–29.5%) FBG variability. We found that higher FBG variability was associated with increased lifetime risk of CVD in men but not women. Similar patterns were observed at index ages 45 and 55 years. Conclusions Higher FBG variability was associated with increased lifetime risk of CVD at each index age. Focusing on the FBG variability may provide an insight to the clinical utility for reducing the lifetime risk of CVD.

Glycaemic variability and risk of adverse cardiovascular events in acute coronary syndrome

“…Subsequently, higher fasting plasma glycaemic variability, an indicator of chronic glycaemic variability, was confirmed to be linked to the increase in lifetime risk of cardiovascular disease, including participants without cardiovascular disease aged 18–98 years with a median follow-up of 7.0 years. 10 Another recent meta-analysis showed that GV was associated with poor prognosis in coronary heart disease, but this study only used MAGE calculated using CGMS during hospitalization as an indicator of GV. 36 Herein, our results expanded these findings.…”

“…6 Recent studies indicated that GV is correlated with a wide variety of diseases resulting in poor prognoses such as sepsis, 7 autonomic dysfunction, 8 and cardiovascular disease 9 in patients with or without diabetes. [10][11][12] The adverse consequences of GV mainly include all-cause, contrast-induced nephropathy, 13 instent restenosis, 14 and so on. In addition, GV has been hypothesized to be deleterious in ACS patients.…”

Association of Visit-to-Visit Variability in Fasting Plasma Glucose with Digestive Cancer Risk

“…High glycemic variability seems to exert more detrimental effects than persistent hyperglycemia on the pathogenesis of diabetic cardiovascular complications [10]. Previously, glycemic variability has been used to predict the diabetic complications, cardiovascular adverse events, and mortality among individuals with or without diabetes [21][22][23][24]. However, whether glycemic variability could serve as an independent risk factor for digestive cancers remained unknown.…”

Separate and combined effect of visit‐to‐visit glycaemic variability and mean fasting blood glucose level on all‐cause mortality in patients with type 2 diabetes: A population‐based cohort study

“…Previous studies have suggested that glucose variability may lead to hypoglycaemia, wide postprandial glucose excursions, and the progression of atherosclerosis, thus affecting the development of diseases later in life 8‐10 . Empirical evidence has shown that greater intra‐individual variation in fasting blood glucose (FBG) is associated with a higher risk of hyperglycaemia, hypoglycaemia and premature mortality 11,12 . Clinical inertia and treatment nonadherence have been major challenges in efforts to optimize glucose‐lowering therapies 13 .…”

“…[8][9][10] Empirical evidence has shown that greater intra-individual variation in fasting blood glucose (FBG) is associated with a higher risk of hyperglycaemia, hypoglycaemia and premature mortality. 11,12 Clinical inertia and treatment nonadherence have been major challenges in efforts to optimize glucose-lowering therapies. 13 The goal of blood glucose control is to reduce glucose levels and glycaemic variability.…”