Effect Of Glucose Variability On Cardiovascular Disease In Non-diabetic Population

Objective::Blood glucose variability carries an increased risk of cardiovascular disease(CVD)in patients with type 2 diabetes,but in non-diabetic subjects,the relationship is not clear.This study aimed to investigate the association between blood glucose variability and the risk of arteriosclerosis and atherosclerotic cardiovascular disease(ASCVD)in non-diabetic subjects.Methods:This study included 4265 volunteers and then excluded 800 volunteers with diabetes,coronary artery disease or newly diagnosed diabetes.Eventually 3465 cases were included in the analysis of our study.The difference between 2h post-prandial plasma glucose and fasting plasma glucose represented blood glucose variability.Based on the average difference as the cut-off point,the participants were divided into the high variability and low variability group.Artery stiffness(an indicator of ASCVD risk)was assessed by pulse wave velocity(PWV).The 10-year ASCVD risk was calculated using the 2013 ACC/AHA Controlled Cholesterol Reduction ASCVD Risk Formula.Results:The high variability group had significantly higher waist,BMI,systolic blood pressure,diastolic blood pressure,HbAlc,total cholesterol,triglyceride,low density lipoprotein,insulin resistance index(HOMA2-IR)Beta-cell function index(HOMA2-%B)(p<0.01)and significantly lower insulin sensitivity index(HOMA2-%S)and HDL(p<0.001)than the low variability group.There was no significant difference in fasting blood glucose level between the two groups(p>0.05).Further,the high variability group also had significantly higher PWV(1442 ±250 vs 1388 ±229 cm/s,p<0.001).Finally,the 10-year ASCVD risk was significantly higher in the high variability group than in the low variability group(6%vs 5%,p<0.001),even after adjusting for confounding factors(OR,1.466 95%Cl,1.202-1.787,p<0.001).Conclusion:In non-diabetic populations,increase in blood glucose variability is associated with an increase in insulin resistance,artery stiffness,and the risk of ASCVD,and glucose variability is an independent risk factor of cardiovascular disease.