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Eun Gyung Hong  (Hong EG) 1 Article
Is A1C Variability an Independent Predictor for the Progression of Atherosclerosis in Type 2 Diabetic Patients?
Chul Sik Kim, So Young Park, Sung Hoon Yu, Jun Goo Kang, Ohk Hyun Ryu, Seong Jin Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo-Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo
Korean Diabetes J. 2010;34(3):174-181.   Published online June 30, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.3.174
  • 4,224 View
  • 29 Download
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

Little is known about the relative contribution of long-term glycemic variability to the risk of macrovascular complications in type 2 diabetes. This study was conducted to evaluate the effect of A1C variability on the progression of carotid artery intima-media thickness (IMT) in type 2 diabetic patients.

Methods

Among type 2 diabetic patients who visited Hallym University Sacred Heart Hospital from March 2007 to September 2009, 120 patients who had carotid artery IMT measured annually and A1C checked every three months for at least one year were analyzed. Individual A1C variability was defined as the standard deviation (SD) of five A1C levels taken every three months for approximately one year. Change in IMT was defined as an increase in IMT on follow-up measurement. The association between the SD of A1C and changes in IMT was evaluated.

Results

With greater A1C variability, there was a greater increase in the mean IMT (r = 0.350, P < 0.001) of the carotid artery. After adjusting for confounding factors that may influence IMT, A1C variability was significantly associated with the progression of IMT (r = 0.222, P = 0.034). However, the SD of A1C was not a significant independent risk factor for the progression of IMT in multiple regression analysis (β = 0.158, P = 0.093).

Conclusion

Higher A1C variability is associated with IMT progression in type 2 diabetic patients; however, it is not an independent predictor of IMT progression. Overall glycemic control is the most important factor in the progression of IMT.

Citations

Citations to this article as recorded by  
  • Long-Term Risk of Cardiovascular Disease Among Type 2 Diabetes Patients According to Average and Visit-to-Visit Variations of HbA1c Levels During the First 3 Years of Diabetes Diagnosis
    Hyunah Kim, Da Young Jung, Seung-Hwan Lee, Jae-Hyoung Cho, Hyeon Woo Yim, Hun-Sung Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Association Between Long-Term Visit-to-Visit Hemoglobin A1c and Cardiovascular Risk in Type 2 Diabetes: The ACCORD Trial
    Dan Huang, Yong-Quan Huang, Qun-Ying Zhang, Yan Cui, Tian-Yi Mu, Yin Huang
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • Association of Longitudinal Values of Glycated Hemoglobin With Cardiovascular Events in Patients With Type 2 Diabetes and Multivessel Coronary Artery Disease
    Paulo Cury Rezende, Mark Andrew Hlatky, Whady Hueb, Rosa Maria Rahmi Garcia, Luciano da Silva Selistre, Eduardo Gomes Lima, Cibele Larrosa Garzillo, Thiago Luis Scudeler, Gustavo Andre Boeing Boros, Fernando Faglioni Ribas, Carlos Vicente Serrano, Jose An
    JAMA Network Open.2020; 3(1): e1919666.     CrossRef
  • Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes
    Yifei Mo, Jian Zhou, Xiaojing Ma, Wei Zhu, Lei Zhang, Jie Li, Jingyi Lu, Cheng Hu, Yuqian Bao, Weiping Jia
    Diabetes and Vascular Disease Research.2018; 15(5): 402.     CrossRef
  • Relationship of HbA1c variability, absolute changes in HbA1c, and all-cause mortality in type 2 diabetes: a Danish population-based prospective observational study
    Mette V Skriver, Annelli Sandbæk, Jette K Kristensen, Henrik Støvring
    BMJ Open Diabetes Research & Care.2015; 3(1): e000060.     CrossRef
  • Association between hemoglobin A1c variability and subclinical coronary atherosclerosis in subjects with type 2 diabetes
    Hae Kyung Yang, Borami Kang, Seung-Hwan Lee, Kun-Ho Yoon, Byung-Hee Hwang, Kiyuk Chang, Kyungdo Han, Gunseog Kang, Jae Hyoung Cho
    Journal of Diabetes and its Complications.2015; 29(6): 776.     CrossRef
  • Glycated hemoglobin as a marker of subclinical atherosclerosis and cardiac remodeling among non-diabetic adults from the general population
    Robin Haring, Sebastian E. Baumeister, Wolfgang Lieb, Bettina von Sarnowski, Henry Völzke, Stephan B. Felix, Matthias Nauck, Henri Wallaschofski
    Diabetes Research and Clinical Practice.2014; 105(3): 416.     CrossRef
  • HbA1c Variability and Micro- and Macrovascular Complications of Diabetes
    Hae Kyung Yang, Seung-Hwan Lee
    The Journal of Korean Diabetes.2014; 15(4): 202.     CrossRef
  • HbA1c variability and the development of microalbuminuria in type 2 diabetes: Tsukuba Kawai Diabetes Registry 2
    A. Sugawara, K. Kawai, S. Motohashi, K. Saito, S. Kodama, Y. Yachi, R. Hirasawa, H. Shimano, K. Yamazaki, H. Sone
    Diabetologia.2012; 55(8): 2128.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal