Associations between continuous glucose monitoring-derived metrics and arterial stiffness in Japanese patients with type 2 diabetes

Cardiovascular Diabetology

Masahiko Gosho¹  Hidenori Yoshii²  Naoto Katakami³  Iichiro Shimomura³  Satomi Wakasugi⁴  Hirotaka Watada⁴  Tomoya Mita⁴  Yosuke Okada⁵  Nobuichi Kuribayashi⁶  Yuichi Kojima⁷  Takeshi Osonoi⁸  Yoshinobu Taneda⁹ 

[1] Department of Biostatistics, Faculty of Medicine, University of Tsukuba;Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center;Department of Metabolic Medicine, Osaka University Graduate School of Medicine;Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine;First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health;Misaki Naika Clinic;Musashino Family Clinic;Nakakinen Clinic;Taneda Clinic;

关键词: Glucose variability;    Continuous glucose monitoring;    Arterial stiffness;    Type 2 diabetes;   

DOI  :  10.1186/s12933-020-01194-2

来源: DOAJ

【 摘 要 】

Abstract Background Previous studies have suggested that high mean glucose levels and glycemic abnormalities such as glucose fluctuation and hypoglycemia accelerate the progression of atherosclerosis in patients with type 2 diabetes. Although continuous glucose monitoring (CGM) that could evaluate such glycemic abnormalities has been rapidly adopted, the associations between CGM-derived metrics and arterial stiffness are not entirely clear. Methods This exploratory cross-sectional study used baseline data from an ongoing prospective, multicenter, observational study with 5 years of follow-up. Study participants included 445 outpatients with type 2 diabetes and no history of apparent cardiovascular disease who underwent CGM and brachial-ankle pulse wave velocity (baPWV) measurement at baseline. Associations between CGM-derived metrics and baPWV were analyzed using multivariate regression models. Results In a linear regression model, all CGM-derived metrics were significantly associated with baPWV, but HbA1c was not. Some CGM-derived metrics related to intra-day glucose variability, hyperglycemia, and hypoglycemia remained significantly associated with baPWV after adjusting for possible atherosclerotic risk factors, including HbA1c. Based on baPWV ≥ 1800 cm/s as indicative of high arterial stiffness, multivariate logistic regression found that some CGM-derived metrics related to intra-day glucose variability and hyperglycemia are significantly associated with high arterial stiffness even after adjusting for possible atherosclerotic risk factors, including HbA1c. Conclusions Multiple CGM-derived metrics are significantly associated with baPWV and high arterial stiffness in patients with type 2 diabetes who have no history of apparent cardiovascular disease. These metrics might be useful for identifying patients at high risk of developing cardiovascular disease.

【 授权许可】

Unknown