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Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes

Heart failure (HF) is a common presentation in patients with type 2 diabetes mellitus (T2DM). Previous studies revealed that the HbA1c level is significantly associated with HF. However, little is known about the association between HbA1c variability and HF. We aimed to evaluate the association of m...

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Autores principales: Lin, You-Ting, Huang, Wei-Lun, Wu, Hung-Pin, Chang, Man-Ping, Chen, Ching-Chu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037774/
https://www.ncbi.nlm.nih.gov/pubmed/33915706
http://dx.doi.org/10.3390/jcm10071401
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author Lin, You-Ting
Huang, Wei-Lun
Wu, Hung-Pin
Chang, Man-Ping
Chen, Ching-Chu
author_facet Lin, You-Ting
Huang, Wei-Lun
Wu, Hung-Pin
Chang, Man-Ping
Chen, Ching-Chu
author_sort Lin, You-Ting
collection PubMed
description Heart failure (HF) is a common presentation in patients with type 2 diabetes mellitus (T2DM). Previous studies revealed that the HbA1c level is significantly associated with HF. However, little is known about the association between HbA1c variability and HF. We aimed to evaluate the association of mean and variability of HbA1c with HF in patients with T2DM. Using Diabetes Share Care Program data, patients with T2DM who had mean HbA1c (HbA1c-Mean), and HbA1c variability (tertiles of HbA1c-SD and HbA1c-adjSD) within 12–24 months during 2001–2008 were included. The cutoffs of HbA1c-Mean were set at <7%, 7–7.9%, and ≥8%. Hazard ratios (HRs) for HF during 2008–2018 were estimated using Cox proportional hazard models. A total of 3824 patients were included, of whom 315 patients developed HF during the observation period of 11.72 years. The associated risk of HF increased with tertiles of HbA1c variability and cutoffs of HbA1c-Mean. In mutually adjusted models, HbA1c-Mean showed a consistent dose-response association with HF, while the association of HbA1c variability with HF disappeared. Among patients with HbA1c-Mean <7%, the associated risk of HF in patients with HbA1c variability in tertile 3 was comparable to patients with HbA1c-Mean ≥8%. In conclusion, mean HbA1c was an independent predictor of HF and not explained by HbA1c variability. In addition to absolute HbA1c level, targeting on stability of HbA1c in patients with good glycemic control was also important for the development of HF in patients with T2DM.
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spelling pubmed-80377742021-04-12 Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes Lin, You-Ting Huang, Wei-Lun Wu, Hung-Pin Chang, Man-Ping Chen, Ching-Chu J Clin Med Article Heart failure (HF) is a common presentation in patients with type 2 diabetes mellitus (T2DM). Previous studies revealed that the HbA1c level is significantly associated with HF. However, little is known about the association between HbA1c variability and HF. We aimed to evaluate the association of mean and variability of HbA1c with HF in patients with T2DM. Using Diabetes Share Care Program data, patients with T2DM who had mean HbA1c (HbA1c-Mean), and HbA1c variability (tertiles of HbA1c-SD and HbA1c-adjSD) within 12–24 months during 2001–2008 were included. The cutoffs of HbA1c-Mean were set at <7%, 7–7.9%, and ≥8%. Hazard ratios (HRs) for HF during 2008–2018 were estimated using Cox proportional hazard models. A total of 3824 patients were included, of whom 315 patients developed HF during the observation period of 11.72 years. The associated risk of HF increased with tertiles of HbA1c variability and cutoffs of HbA1c-Mean. In mutually adjusted models, HbA1c-Mean showed a consistent dose-response association with HF, while the association of HbA1c variability with HF disappeared. Among patients with HbA1c-Mean <7%, the associated risk of HF in patients with HbA1c variability in tertile 3 was comparable to patients with HbA1c-Mean ≥8%. In conclusion, mean HbA1c was an independent predictor of HF and not explained by HbA1c variability. In addition to absolute HbA1c level, targeting on stability of HbA1c in patients with good glycemic control was also important for the development of HF in patients with T2DM. MDPI 2021-04-01 /pmc/articles/PMC8037774/ /pubmed/33915706 http://dx.doi.org/10.3390/jcm10071401 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lin, You-Ting
Huang, Wei-Lun
Wu, Hung-Pin
Chang, Man-Ping
Chen, Ching-Chu
Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes
title Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes
title_full Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes
title_fullStr Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes
title_full_unstemmed Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes
title_short Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes
title_sort association of mean and variability of hba1c with heart failure in patients with type 2 diabetes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037774/
https://www.ncbi.nlm.nih.gov/pubmed/33915706
http://dx.doi.org/10.3390/jcm10071401
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