Associations Between Continuous Glucose Monitoring-derived Metrics and Arterial Stiffness in Patients with Type 2 Diabetes
Background Previous studies have suggested that high mean glucose levels and various 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 is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 445 outpatients with type 2 diabetes who underwent CGM and brachial-ankle pulse wave velocity (baPWV) measurement at baseline. Associations between CGM-derived metrics and baPWV were investigated 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 ≥1,800 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.
This study has been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000032325).
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Posted 22 Sep, 2020
On 07 Jan, 2021
On 18 Oct, 2020
Received 14 Oct, 2020
Received 14 Oct, 2020
Received 12 Oct, 2020
Invitations sent on 24 Sep, 2020
On 24 Sep, 2020
On 24 Sep, 2020
On 24 Sep, 2020
On 24 Sep, 2020
On 23 Sep, 2020
On 22 Sep, 2020
On 19 Sep, 2020
On 15 Sep, 2020
Associations Between Continuous Glucose Monitoring-derived Metrics and Arterial Stiffness in Patients with Type 2 Diabetes
Posted 22 Sep, 2020
On 07 Jan, 2021
On 18 Oct, 2020
Received 14 Oct, 2020
Received 14 Oct, 2020
Received 12 Oct, 2020
Invitations sent on 24 Sep, 2020
On 24 Sep, 2020
On 24 Sep, 2020
On 24 Sep, 2020
On 24 Sep, 2020
On 23 Sep, 2020
On 22 Sep, 2020
On 19 Sep, 2020
On 15 Sep, 2020
Background Previous studies have suggested that high mean glucose levels and various 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 is an exploratory analysis of an ongoing prospective, multicenter, 5-year follow-up observational study. Study participants included 445 outpatients with type 2 diabetes who underwent CGM and brachial-ankle pulse wave velocity (baPWV) measurement at baseline. Associations between CGM-derived metrics and baPWV were investigated 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 ≥1,800 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.
This study has been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000032325).