Risk association of HbA1c variability with chronic kidney disease and cardiovascular disease in type 2 diabetes: prospective analysis of the Hong Kong Diabetes Registry
| Autor: | Andrea O Y, Luk, Ronald C W, Ma, Eric S H, Lau, Xilin, Yang, Winnie W Y, Lau, Linda W L, Yu, Francis C C, Chow, Juliana C N, Chan, Wing-Yee, So |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Glycated Hemoglobin Male Diabetic Cardiomyopathies Incidence Middle Aged Prognosis Cohort Studies Diabetes Mellitus Type 2 Cardiovascular Diseases Risk Factors Hyperglycemia Hong Kong Humans Diabetic Nephropathies Female Prospective Studies Registries Renal Insufficiency Chronic Diabetic Angiopathies Aged Follow-Up Studies |
| Zdroj: | Diabetes/metabolism research and reviews. 29(5) |
| ISSN: | 1520-7560 |
| Popis: | In type 2 diabetes, tight glycaemic control lowers the risk of diabetic complications, but it remains uncertain whether variability of glycaemia influences outcomes. We examined the association of glycated haemoglobin (HbA1c ) variability with incident chronic kidney disease and cardiovascular disease in a prospective cohort of 8439 Chinese patients with type 2 diabetes recruited from 1994 to 2007.Intrapersonal mean and SD of serially measured HbA1c were calculated. Chronic kidney disease was defined as estimated glomerular filtration rate60 ml/min per 1.73 m². Cardiovascular disease was defined as events of ischemic heart disease, heart failure, ischemic stroke or peripheral vascular disease.Over a median follow-up period of 7.2 years, 19.7 and 10.0% of patients developed chronic kidney disease and cardiovascular disease, respectively. Patients who progressed to chronic kidney disease had higher mean HbA1c (7.8 ± 1.3% vs 7.4 ± 1.2%, p 0.001) and SD (1.0 ± 0.8% vs 0.8 ± 0.6%, p 0.001) than nonprogressors. Similarly, patients who developed cardiovascular disease had higher mean HbA1c (7.7 ± 1.3% vs 7.4 ± 1.2%, p 0.001) and SD (1.4 ± 1.1% vs 1.1 ± 0.8%, p 0.001) than patients who did not develop cardiovascular disease. By using multivariate-adjusted Cox regression analysis, adjusted SD was associated with incident chronic kidney disease and cardiovascular disease with corresponding hazard ratios of 1.16 (95% CI 1.11-1.22), p 0.001) and 1.27 (95% CI 1.15-1.40, p 0.001), independent of mean HbA1c and other confounding variables.Long-term glycaemic variability expressed by SD of HbA1c predicted development of renal and cardiovascular complications. |
| Databáze: | OpenAIRE |
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