Suhua Li1, Zhenda Zheng1, Xixiang Tang2, Junlin Zhong3, Xing Liu1, Yunyue Zhao1, Lin Chen1, Jieming Zhu4, Jinlai Liu5, Yanming Chen6. 1. Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. 2. Department of Endocrinology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; Advanced Medical Center, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. 3. Department of Ultrasonography, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. 4. Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. Electronic address: zhujieming2011@126.com. 5. Department of Cardiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. Electronic address: medicine2lsh@163.com. 6. Department of Endocrinology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China. Electronic address: yanmingch@qq.com.
Abstract
BACKGROUND: Glycemic instability confers a risk of poor prognosis in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate whether HbA1c variability provided additional value over mean HbA1c for predicting subclinical left ventricular remodeling and dysfunction in T2DM patients. METHODS: A total of 466 T2DM patients with normal cardiac structure and function were recruited and prospectively followed up for a median of 4.7 y. HbA1c was measured quarterly. The intrapersonal mean and standard deviation (SD) of HbA1c measurements were calculated, and SD-HbA1c was considered as a measure of HbA1c variability. All participants underwent transthoracic echocardiography at baseline and after follow-up. RESULTS: In multivariable regression analyses, SD-HbA1c was independently associated with annualized changes in left ventricular end diastolic diameter, interventricular septum, left ventricular posterior wall, left ventricular mass index, left ventricular ejection fraction, E/e' ratio, and E/A ratio (P < 0.001). Subgroup analysis based on mean HbA1c levels (<7.0%, 7.0-7.5%, and ≥7.5%) further confirmed that SD-HbA1c was associated with most of the above parameters regardless of mean HbA1c levels. CONCLUSION: This study indicates that HbA1c variability adds to the mean value in predicting subclinical left ventricular remodeling and dysfunction in T2DM patients.
BACKGROUND: Glycemic instability confers a risk of poor prognosis in patients with type 2 diabetes mellitus (T2DM). This study aimed to investigate whether HbA1c variability provided additional value over mean HbA1c for predicting subclinical left ventricular remodeling and dysfunction in T2DMpatients. METHODS: A total of 466 T2DMpatients with normal cardiac structure and function were recruited and prospectively followed up for a median of 4.7 y. HbA1c was measured quarterly. The intrapersonal mean and standard deviation (SD) of HbA1c measurements were calculated, and SD-HbA1c was considered as a measure of HbA1c variability. All participants underwent transthoracic echocardiography at baseline and after follow-up. RESULTS: In multivariable regression analyses, SD-HbA1c was independently associated with annualized changes in left ventricular end diastolic diameter, interventricular septum, left ventricular posterior wall, left ventricular mass index, left ventricular ejection fraction, E/e' ratio, and E/A ratio (P < 0.001). Subgroup analysis based on mean HbA1c levels (<7.0%, 7.0-7.5%, and ≥7.5%) further confirmed that SD-HbA1c was associated with most of the above parameters regardless of mean HbA1c levels. CONCLUSION: This study indicates that HbA1c variability adds to the mean value in predicting subclinical left ventricular remodeling and dysfunction in T2DMpatients.
Authors: Antonio Ceriello; Giuseppe Lucisano; Francesco Prattichizzo; Rosalba La Grotta; Stefan Franzén; Ann-Marie Svensson; Björn Eliasson; Antonio Nicolucci Journal: Cardiovasc Diabetol Date: 2022-01-24 Impact factor: 9.951