A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus

GU Shujun; QIN Yu; YU Hao; GUAN Haoyu; CUI Lan; SHEN Chong; LU Yan; CHENG Tingting; ZHANG Ning; ZHOU Jinyi; SU Jian

doi:10.16462/j.cnki.zhjbkz.2024.07.006

Volume 28 Issue 7

Jul. 2024

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GU Shujun, QIN Yu, YU Hao, GUAN Haoyu, CUI Lan, SHEN Chong, LU Yan, CHENG Tingting, ZHANG Ning, ZHOU Jinyi, SU Jian. A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(7): 777-783. doi: 10.16462/j.cnki.zhjbkz.2024.07.006

Citation:

GU Shujun, QIN Yu, YU Hao, GUAN Haoyu, CUI Lan, SHEN Chong, LU Yan, CHENG Tingting, ZHANG Ning, ZHOU Jinyi, SU Jian. A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(7): 777-783. doi: 10.16462/j.cnki.zhjbkz.2024.07.006

Citation:

GU Shujun, QIN Yu, YU Hao, GUAN Haoyu, CUI Lan, SHEN Chong, LU Yan, CHENG Tingting, ZHANG Ning, ZHOU Jinyi, SU Jian. A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(7): 777-783. doi: 10.16462/j.cnki.zhjbkz.2024.07.006

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A prospective cohort study on the long-term fasting plasma glucose variability and risk of stroke among patients with type 2 diabetes mellitus

doi: 10.16462/j.cnki.zhjbkz.2024.07.006

1.
Department of Non-communicable Disease Prevention, Changshu County Center for Disease Control and Prevention, Changshu 215500, China
2.
Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
3.
Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
4.
Department of Non-communicable Disease Prevention, Suzhou City Center for Disease Control and Prevention, Suzhou 215004, China
5.
Department of Infectious Disease Control Division, Suzhou Hi-Tech District (Huqiu District) Center for Disease Control and Prevention, Suzhou 215011, China

Funds:

Jiangsu Provincial Health Commission 2020 Medical Research Project Approval M2020085

Gusu Health Talent Training Project of Suzhou GSWS2020107

Jiangsu Province Leading Talents and Innovation Team Program K201105

Jiangsu Provincial Fifth "333 Project" BRA2020090

Suzhou Science and Technology Plan Projects SS202010

Changshu Science and Technology Plan Projects CS201812

More Information

Corresponding author: SU Jian，E-mail: sujiangx@163.com
Received Date: 2023-07-28
Rev Recd Date: 2024-01-09

Available Online: 2024-08-19

Publish Date: 2024-07-10

Abstract

Abstract

Objective To investigate the association between long-term fasting plasma glucose (FPG) variability and stroke in patients with type 2 diabetes mellitus (T2DM). Methods The participants were from a community-based diabetes cohort established in Changshu from 2013 to 2014 (n=6 247). Long-term glucose variability was assessed using the standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and variability independent of the mean (VIM) across FPG measurements obtained at the more than three visits. The risk of stroke in patients with T2DM was estimated using Cox proportional risk regression models for SD, CV, ARV, VIM and stratified analysis were conducted according to age, gender and history of diabetes medication. Results After an average 7.26 years of follow-up, there were 1 080 incident cases of stroke, giving a crude incidence rate of 23.81/1 000 person-years. The long-term fasting plasma glucose variability was grouped by tertiles (T1-T3). After adjustment, Cox regression analysis showed that compared with the T1 group, FPG-SD, FPG-CV, FPG-ARV and FPG-VIM in T2 and T3 groups were significantly increased the risks of stroke (P_trend ＜ 0.01). Per 1 standard deviation(SD) higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of stroke was significantly increased, the HR (95% CI) were 1.09(1.02-1.16), 1.09(1.03-1.16), 1.08(1.02-1.16) and 1.10(1.03-1.16) respectively. Per 1 SD higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of ischemic stroke was significantly increased, the HR (95% CI) were 1.11(1.03-1.19), 1.11(1.04-1.18), 1.08(1.00-1.15), 1.04(1.04-1.17), respectively. Per 1 SD higher of FPG-ARV, the risk of hemorrhagic stroke was significantly increased, the HR(95% CI) was 1.25(1.05-1.48). Stratified analysis showed that in the patients of ≥65 years of age (except FPG-CV), women and oral hypoglycemic agents, per 1 SD higher of FPG-SD, FPG-CV, FPG-ARV and FPG-VIM, the risk of ischemic stroke increased significantly (P ＜ 0.05). Conclusions Long-term FPG glycemic variability is positively associated with the risk of stroke in type 2 diabetes patients.
- Fasting plasma glucose variability,
- Type 2 diabetes mellitus,
- Stroke,
- Cohort study

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References(17)

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