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Open Access Original investigation

Glycemic variability is associated with subclinical atherosclerosis in Chinese type 2 diabetic patients

Yifei Mo1, Jian Zhou1, Mei Li2, Yuwei Wang13, Yuqian Bao1, Xiaojing Ma1, Ding Li1, Wei Lu1, Cheng Hu1, Minghua Li2 and Weiping Jia1*

Author Affiliations

1 Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai, 200233, China

2 Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

3 Department of Biochemistry, Microbiology and Immunology, Ottawa Institute of Systems Biology, University of Ottawa, Ottawa, Ontario, Canada

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Cardiovascular Diabetology 2013, 12:15  doi:10.1186/1475-2840-12-15

Published: 15 January 2013

Abstract

Background

The contribution of glycemic variability to macrovascular complications remains unclear. We therefore investigated the association between glycemic variability and cervical and/or intracranial atherosclerosis in Chinese type 2 diabetic patients.

Methods

We conducted a cross-sectional study in 216 type 2 diabetic patients with a hemoglobin A1c of 8.3 ± 1.7% and a median diabetes duration of 9.0 years. The standard deviation of blood glucose values (SDBG) and the mean amplitude of glycemic excursion (MAGE) were calculated from continuous glucose monitoring system data for assessing glycemic variability while 24h mean blood glucose (MBG) was calculated for measuring overall blood glucose level. Magnetic resonance angiography (MRA) was used to detect cervical and/or intracranial plaque, and ultrasonography was used to quantify carotid intima-media thickness (IMT) as an index of subclinical atherosclerosis.

Results

One hundred and fifty-three patients (70.8%) presented with cervical and/or intracranial lesions on MRA among 216 patients in the study. Elder age, increased systolic blood pressure, increased MBG and elevated low density lipoprotein cholesterol were independent contributors to plaque formation. In patients without stenosis (n = 63), SDBG (r = 0.412, P = 0.001) and MAGE (r = 0.365, P = 0.005) were both correlated with carotid IMT and these relationships remained significant in multiple linear regression analysis (multiple R2 = 0.314 for the model including SDBG and multiple R2 = 0.268 for the model including MAGE). However, SDBG and MAGE were not significantly different among patients with different stenosis degrees.

Conclusions

Glycemic variability is associated with subclinical atherosclerosis in Chinese type 2 diabetic patients.

Keywords:
Glycemic variability; Type 2 diabetes; Atherosclerosis; Intima-media thickness; Magnetic resonance angiography.