Display options
Cite
Bouchi R, Babazono T, Mugishima M, et al. Fluctuations in HbA1c are associated with a higher incidence of cardiovascular disease in Japanese patients with type 2 diabetes. J Diabetes Investig. 2012;3(2):148-55doi: 10.1111/j.2040-1124.2011.00155.x.
Bouchi, R., Babazono, T., Mugishima, M., Yoshida, N., Nyumura, I., Toya, K., Hayashi, T., Hanai, K., Tanaka, N., Ishii, A., & Iwamoto, Y. (2012). Fluctuations in HbA1c are associated with a higher incidence of cardiovascular disease in Japanese patients with type 2 diabetes. Journal of diabetes investigation, 3(2), 148-55. https://doi.org/10.1111/j.2040-1124.2011.00155.x
Bouchi, Ryotaro, et al. "Fluctuations in HbA1c are associated with a higher incidence of cardiovascular disease in Japanese patients with type 2 diabetes." Journal of diabetes investigation vol. 3,2 (2012): 148-55. doi: https://doi.org/10.1111/j.2040-1124.2011.00155.x
Bouchi R, Babazono T, Mugishima M, Yoshida N, Nyumura I, Toya K, Hayashi T, Hanai K, Tanaka N, Ishii A, Iwamoto Y. Fluctuations in HbA1c are associated with a higher incidence of cardiovascular disease in Japanese patients with type 2 diabetes. J Diabetes Investig. 2012 Mar 28;3(2):148-55. doi: 10.1111/j.2040-1124.2011.00155.x. PMID: 24843558; PMCID: PMC4020732.
Copy Download .nbib Format: NLM
Share it on

J Diabetes Investig. 2012 Mar 28;3(2):148-55. doi: 10.1111/j.2040-1124.2011.00155.x.

Fluctuations in HbA1c are associated with a higher incidence of cardiovascular disease in Japanese patients with type 2 diabetes.

Journal of diabetes investigation

Ryotaro Bouchi, Tetsuya Babazono, Michino Mugishima, Naoshi Yoshida, Izumi Nyumura, Kiwako Toya, Toshihide Hayashi, Ko Hanai, Nobue Tanaka, Akiko Ishii, Yasuhiko Iwamoto

Affiliations

  1. Division of Nephrology and Hypertension.
  2. Department of Medicine, Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

PMID: 24843558 PMCID: PMC4020732 DOI: 10.1111/j.2040-1124.2011.00155.x

Abstract

UNLABELLED: Aims/Introduction:  To reveal whether visit-to-visit variability in HbA1c is associated with higher risk of cardiovascular disease (CVD) in patients with type 2 diabetes.

MATERIALS AND METHODS:   The study was conducted on 689 Japanese patients with type 2 diabetes [295 women, 394 men; mean (±standard deviations (SD)) age 65 ± 11 years]. Variability in HbA1c was evaluated as the intrapersonal SD of serial measurements of HbA1c during the follow-up period for at least 12 months. Patients were divided into quartiles according to the SD of HbA1c, and the primary endpoint was defined as incident CVD. Cox's proportional hazards model was used to calculate hazard ratios (HR) and 95% confidence intervals (CI).

RESULTS:   During a median follow-up period of 3.3 years (range 1.0-6.3 years), 26 ± 14 measurements of HbA1c were obtained per patient and 61 episodes of incident CVD were recorded. The 5-year cumulative incidence of CVD in patients across the first, second, third, and fourth quartiles of SD in HbA1c was 4.9, 8.7, 17.1, and 26.2%, respectively (P < 0.001, log-rank test). Multivariate Cox regression analysis revealed that the incidence of CVD was significantly higher in patients in the fourth quartile of SD in HbA1c compared with those in the first quartile (HR 3.38; 95% CI 1.07-10.63; P = 0.039), independent of mean HbA1c and other traditional cardiovascular risk factors.

CONCLUSIONS:   Variability of HbA1c may be a potent predictor of incident CVD in Japanese patients with type 2 diabetes. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00155.x, 2011).

Keywords: Cardiovascular disease; HbA1c variability; Type 2 diabetes

References

  1. Diabetes Care. 2004 Jan;27 Suppl 1:S79-83 - PubMed
  2. Stroke. 1996 Feb;27(2):210-5 - PubMed
  3. Circulation. 2006 Mar 21;113(11):e463-654 - PubMed
  4. JAMA. 1979 May 11;241(19):2035-8 - PubMed
  5. Am Heart J. 2006 Jul;152(1):27-38 - PubMed
  6. JAMA. 2006 Apr 12;295(14):1681-7 - PubMed
  7. Diabetologia. 2007 Nov;50(11):2280-8 - PubMed
  8. Diabetes Care. 2008 Nov;31(11):2198-202 - PubMed
  9. Circulation. 1999 Jan 19;99(2):224-9 - PubMed
  10. N Engl J Med. 2009 Jan 8;360(2):129-39 - PubMed
  11. Am J Kidney Dis. 2009 Jun;53(6):982-92 - PubMed
  12. N Engl J Med. 2008 Jun 12;358(24):2560-72 - PubMed
  13. N Engl J Med. 1993 Sep 30;329(14):977-86 - PubMed
  14. Ann Intern Med. 2004 Sep 21;141(6):421-31 - PubMed
  15. Lancet. 1998 Sep 12;352(9131):837-53 - PubMed
  16. Nat Clin Pract Endocrinol Metab. 2005 Dec;1(2):100-10 - PubMed
  17. N Engl J Med. 2008 Jun 12;358(24):2545-59 - PubMed
  18. J Diabetes Investig. 2010 Oct 19;1(5):212-28 - PubMed
  19. Clin Chem. 1972 Jun;18(6):499-502 - PubMed
  20. Diabetes. 2009 Nov;58(11):2649-55 - PubMed
  21. Diabetologia. 2010 Jul;53(7):1270-87 - PubMed
  22. Diabet Med. 2010 May;27(5):538-43 - PubMed
  23. Diabetes. 2008 May;57(5):1349-54 - PubMed
  24. Diabetes. 1996 Jul;45 Suppl 3:S14-6 - PubMed
  25. FEBS Lett. 1995 Jul 17;368(2):225-9 - PubMed
  26. Diabet Med. 1998 Jul;15(7):539-53 - PubMed

Publication Types