Association of glycemic variability and the presence and severity of coronary artery disease in patients with type 2 diabetesReport as inadecuate




Association of glycemic variability and the presence and severity of coronary artery disease in patients with type 2 diabetes - Download this document for free, or read online. Document in PDF available to download.

Cardiovascular Diabetology

, 10:19

First Online: 25 February 2011Received: 25 December 2010Accepted: 25 February 2011

Abstract

BackgroundGlucose variability is one of components of the dysglycemia in diabetes and may play an important role in development of diabetic vascular complications. The objective of this study was to assess the relationship between glycemic variability determined by a continuous glucose monitoring CGM system and the presence and severity of coronary artery disease CAD in patients with type 2 diabetes mellitus T2DM.

MethodsIn 344 T2DM patients with chest pain, coronary angiography revealed CAD coronary stenosis ≥ 50% luminal diameter narrowing in 252 patients and 92 patients without CAD. Gensini score was used to assess the severity of CAD. All participants- CGM parameters and biochemical characteristics were measured at baseline.

ResultsDiabetic patients with CAD were older, and more were male and cigarette smokers compared with the controls. Levels of the mean amplitude of glycemic excursions MAGE 3.7 ± 1.4 mmol-L vs. 3.2 ± 1.2 mmol-L, p < 0.001, postprandial glucose excursion PPGE 3.9 ± 1.6 mmol-L vs. 3.6 ± 1.4 mmol-L, p = 0.036, serum high-sensitive C-reactive protein hs-CRP 10.7 ± 12.4 mg-L vs. 5.8 ± 6.7 mg-L, p < 0.001 and creatinine Cr 87 ± 23 mmol-L vs. 77 ± 14 mmol-L, p < 0.001 were significantly higher in patients with CAD than in patients without CAD. Gensini score closely correlated with age, MAGE, PPGE, hemoglobin A1c HbA1c, hs-CRP and total cholesterol TC. Multivariate analysis indicated that age p < 0.001, MAGE p < 0.001, serum levels of HbA1c p = 0.022 and hs-CRP p = 0.005 were independent determinants for Gensini score. Logistic regression analysis revealed that MAGE ≥ 3.4 mmol-L was an independent predictor for CAD. The area under the receiver-operating characteristic curve for MAGE 0.618, p = 0.001 was superior to that for HbA1c 0.554, p = 0.129.

ConclusionsThe intraday glycemic variability is associated with the presence and severity of CAD in patients with T2DM. Effects of glycemic excursions on vascular complications should not be neglected in diabetes.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-10-19 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Author: Gong Su - Shuhua Mi - Hong Tao - Zhao Li - Hongxia Yang - Hong Zheng - Yun Zhou - Changsheng Ma

Source: https://link.springer.com/article/10.1186/1475-2840-10-19







Related documents