Visit-to-visit variability of glycated albumin was associated with incidence or progression of lower extremity atherosclerotic disease

Abstract

Background The aim of this study was to investigate the association of visit-to-visit variability of hemoglobin A1c (HbA1c) and glycated albumin (GA) with the risk of lower extremity atherosclerotic disease (LEAD). Method We performed a prospective cohort study of 436 patients with type 2 diabetes (258 men and 178 women) with at least 3 measurements of HbA1c and GA prior to baseline investigation from the Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital. Different HbA1c and GA variability markers were calculated. Multivariable Cox proportional hazard regression models were used to demonstrate the association between visit-to-visit HbA1c and GA variability and the risk of incident or progressive LEAD. Results During a mean follow-up period of 3.77 years, 112 participants developed LEAD. Multivariate-adjusted hazard ratios (HRs) of LEAD across tertiles of GA-CV values were 1.00, 1.06 (95% confidence interval [CI] 0.65–1.75), and 1.71 (95% CI 1.07–2.73) (P for trend = 0.042), respectively. When we used GA-VIM and GA-ARV values as exposures, similar positive associations with the risk of LEAD primary were found. Multivariate-adjusted HRs of LEAD for each 1 unit increase in GA-CV, GA-VIM and GA-ARV were 1.03 (95% CI 1.01–1.06), 1.32 (95% CI 1.03–1.69), and 1.07 (95%CI 1.01–1.15), respectively. However, there was no significant association between visit-to-visit variability of HbA1c and the risk of LEAD. Conclusions Visit-to-visit variability of GA may be an optimal biomarker in relation to LEAD risk among patients with type 2 diabetes.

Long‐Term Visit‐to‐Visit Glycemic Variability as a Predictor of Major Adverse Limb and Cardiovascular Events in Patients With Diabetes

“…A recent study reported that GV in patients without diabetes was found to increase the incidence of PAD in Korea. 12 , 13 , 14 …”

Association of Advanced Glycation End Products With Lower-Extremity Atherosclerotic Disease in Type 2 Diabetes Mellitus

“…Seven arteries including femoral artery, deep femoral artery, superficial femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery, and peroneal artery in each lower limb were measured for atherosclerotic plaque. The definition of atherosclerotic plaque have been described in detail previously, i.e., a focal structure encroaching into the arterial lumen ≥ 0.5 mm, 50% of the surrounding intima-media thickness (IMT) value, or an IMT thickness ≥ 1.5 mm (14)(15)(16). The presence of atherosclerotic plaques in any of the lower limb artery segments listed above was defined as LEAD (17).…”