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Greater daily glucose variability and lower time in range assessed with continuous glucose monitoring are associated with greater aortic stiffness: The Maastricht Study
- Source :
- Diabetologia, 64(8), 1880-1892. Springer, Cham, Diabetologia
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Aims CVD is the main cause of morbidity and mortality in individuals with diabetes. It is currently unclear whether daily glucose variability contributes to CVD. Therefore, we investigated whether glucose variability is associated with arterial measures that are considered important in CVD pathogenesis. Methods We included participants of The Maastricht Study, an observational population-based cohort, who underwent at least 48 h of continuous glucose monitoring (CGM) (n = 853; age: 59.9 ± 8.6 years; 49% women, 23% type 2 diabetes). We studied the cross-sectional associations of two glucose variability indices (CGM-assessed SD [SDCGM] and CGM-assessed CV [CVCGM]) and time in range (TIRCGM) with carotid–femoral pulse wave velocity (cf-PWV), carotid distensibility coefficient, carotid intima–media thickness, ankle–brachial index and circumferential wall stress via multiple linear regression. Results Higher SDCGM was associated with higher cf-PWV after adjusting for demographics, cardiovascular risk factors and lifestyle factors (regression coefficient [B] per 1 mmol/l SDCGM [and corresponding 95% CI]: 0.413 m/s [0.147, 0.679], p = 0.002). In the model additionally adjusted for CGM-assessed mean sensor glucose (MSGCGM), SDCGM and MSGCGM contributed similarly to cf-PWV (respective standardised regression coefficients [st.βs] and 95% CIs of 0.065 [−0.018, 0.167], p = 0.160; and 0.059 [−0.043, 0.164], p = 0.272). In the fully adjusted models, both higher CVCGM (B [95% CI] per 10% CVCGM: 0.303 m/s [0.046, 0.559], p = 0.021) and lower TIRCGM (B [95% CI] per 10% TIRCGM: −0.145 m/s [−0.252, −0.038] p = 0.008) were statistically significantly associated with higher cf-PWV. Such consistent associations were not observed for the other arterial measures. Conclusions Our findings show that greater daily glucose variability and lower TIRCGM are associated with greater aortic stiffness (cf-PWV) but not with other arterial measures. If corroborated in prospective studies, these results support the development of therapeutic agents that target both daily glucose variability and TIRCGM to prevent CVD. Graphical abstract
- Subjects :
- Blood Glucose
Male
Time Factors
Endocrinology, Diabetes and Metabolism
Blood Pressure
Type 2 diabetes
030204 cardiovascular system & hematology
0302 clinical medicine
Continuous glucosemonitoring
Prospective Studies
OXIDATIVE STRESS
Prospective cohort study
Continuous glucose monitoring
Pulse wave velocity
ALL-CAUSE MORTALITY
education.field_of_study
CARDIOVASCULAR RISK
Middle Aged
Arterial stiffness
Carotid Arteries
Cohort
Cardiology
Female
Aortic stiffness
medicine.medical_specialty
Population
030209 endocrinology & metabolism
Pulse Wave Analysis
Risk Assessment
Article
COGNITIVE PERFORMANCE
MECHANISMS
Prediabetic State
03 medical and health sciences
Vascular Stiffness
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Humans
education
Aged
GLYCEMIC VARIABILITY
business.industry
Blood Glucose Self-Monitoring
Glucose variability
medicine.disease
INDIVIDUALS
Cross-Sectional Studies
Diabetes Mellitus, Type 2
MYOCARDIAL-INFARCTION
Time in range
DIABETIC COMPLICATIONS
business
Diabetic Angiopathies
Subjects
Details
- ISSN :
- 14320428 and 0012186X
- Volume :
- 64
- Database :
- OpenAIRE
- Journal :
- Diabetologia
- Accession number :
- edsair.doi.dedup.....75984c1c6e0ce4ecdbf1c98cc55ed434