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Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study
Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes. We used the National Health In...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709246/ https://www.ncbi.nlm.nih.gov/pubmed/31335679 http://dx.doi.org/10.1097/MD.0000000000016317 |
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author | Yu, Ji Hee Han, Kyungdo Park, Sanghyun Lee, Da Young Nam, Ga Eun Seo, Ji A Kim, Sin Gon Baik, Sei Hyun Park, Yong Gyu Kim, Seon Mee Kim, Nan Hee Choi, Kyung Mook |
author_facet | Yu, Ji Hee Han, Kyungdo Park, Sanghyun Lee, Da Young Nam, Ga Eun Seo, Ji A Kim, Sin Gon Baik, Sei Hyun Park, Yong Gyu Kim, Seon Mee Kim, Nan Hee Choi, Kyung Mook |
author_sort | Yu, Ji Hee |
collection | PubMed |
description | Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes. We used the National Health Insurance Service, providing a population-based, nationwide database of Koreans. We included individuals without diabetes who underwent glucose measurement at least 3 times during 2002 to 2006. GV was calculated as standard deviation (SD) of fasting plasma glucose (FPG) levels. We observed development of CVD or all-cause death from 2007 to 2015, and also evaluated the mortality within 1 year after CVD. Among 3,211,319 people, we found 23,374 incident cases of myocardial infarction (MI), 27,705 cases of stroke, and 63,275 deaths during 8.3 years of follow-up. After multivariate adjustment, GV was found to be a significant predictor of MI, stroke and all-cause death for their highest quartile, with corresponding hazard ratios (HR) of 1.08 (95% confidence interval, CI 1.04–1.11), 1.09 (95% CI 1.06–1.13), and 1.12 (95% CI 1.10–1.15), respectively. The risk of death increased more in those who had both impaired fasting glucose and the highest quartile of GV (HR 1.24 [95% CI 1.21–1.28]). Moreover, early death rate after 1 year of CVD was higher in the highest quartile of GV compared to the lowest quartile (HR 1.21 [95% CI 1.03–1.41]). Long-term FPG variation was independently associated with CVD and mortality in a general population without diabetes. |
format | Online Article Text |
id | pubmed-6709246 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67092462019-10-01 Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study Yu, Ji Hee Han, Kyungdo Park, Sanghyun Lee, Da Young Nam, Ga Eun Seo, Ji A Kim, Sin Gon Baik, Sei Hyun Park, Yong Gyu Kim, Seon Mee Kim, Nan Hee Choi, Kyung Mook Medicine (Baltimore) Research Article Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes. We used the National Health Insurance Service, providing a population-based, nationwide database of Koreans. We included individuals without diabetes who underwent glucose measurement at least 3 times during 2002 to 2006. GV was calculated as standard deviation (SD) of fasting plasma glucose (FPG) levels. We observed development of CVD or all-cause death from 2007 to 2015, and also evaluated the mortality within 1 year after CVD. Among 3,211,319 people, we found 23,374 incident cases of myocardial infarction (MI), 27,705 cases of stroke, and 63,275 deaths during 8.3 years of follow-up. After multivariate adjustment, GV was found to be a significant predictor of MI, stroke and all-cause death for their highest quartile, with corresponding hazard ratios (HR) of 1.08 (95% confidence interval, CI 1.04–1.11), 1.09 (95% CI 1.06–1.13), and 1.12 (95% CI 1.10–1.15), respectively. The risk of death increased more in those who had both impaired fasting glucose and the highest quartile of GV (HR 1.24 [95% CI 1.21–1.28]). Moreover, early death rate after 1 year of CVD was higher in the highest quartile of GV compared to the lowest quartile (HR 1.21 [95% CI 1.03–1.41]). Long-term FPG variation was independently associated with CVD and mortality in a general population without diabetes. Wolters Kluwer Health 2019-07-19 /pmc/articles/PMC6709246/ /pubmed/31335679 http://dx.doi.org/10.1097/MD.0000000000016317 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | Research Article Yu, Ji Hee Han, Kyungdo Park, Sanghyun Lee, Da Young Nam, Ga Eun Seo, Ji A Kim, Sin Gon Baik, Sei Hyun Park, Yong Gyu Kim, Seon Mee Kim, Nan Hee Choi, Kyung Mook Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study |
title | Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study |
title_full | Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study |
title_fullStr | Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study |
title_full_unstemmed | Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study |
title_short | Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study |
title_sort | effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: a nationwide population-based study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709246/ https://www.ncbi.nlm.nih.gov/pubmed/31335679 http://dx.doi.org/10.1097/MD.0000000000016317 |
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