Visit-to-visit fasting plasma glucose variability is an important risk factor for long-term changes in left cardiac structure and function in patients with type 2 diabetes

摘要

To investigate the effect of visit-to-visit fasting plasma glucose (FPG) variability on the left cardiac structure and function in patients with type 2 diabetes mellitus (T2DM). In this prospective cohort study, 455 T2DM patients were included and follow-up for a median of 4.7?years. FPG measured on every hospital visit was collected. FPG variability was calculated by its coefficient of variation (CV-FPG). Left cardiac structure and function were assessed using echocardiography at baseline and after follow-up. Multivariable linear regression analyses were used to estimate the effect of FPG variability on the annualized changes in left cardiac structure and function. Subgroup analysis stratified by mean HbA1c levels (?7% and?≥?7%) were also performed. In multivariable regression analyses, CV-FPG was independently associated with the annualized changes in left ventricle (β?=?0.137; P?=?0.031), interventricular?septum (β?=?0.215; P?=?0.001), left ventricular posterior wall thickness (β?=?0.129; P?=?0.048), left ventricular mass index (β?=?0.227; P??0.001), and left ventricular ejection fraction (β?=???0.132; P?=?0.030). After additionally stratified by mean HbA1c levels, CV-FPG was still independently associated with the annualized changes in the above parameters in patients with HbA1c?≥?7%, while not in patients with HbA1c??7%. Visit-to-visit variability in FPG could be a novel risk factor for the long-term adverse changes in left cardiac structure and systolic function in patients with type 2 diabetes.