Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study

Ji Hee Yu, Kyungdo Han, Sanghyun Park, Da Young Lee, Ga Eun Nam, Ji A. Seo, Sin Gon Kim, Sei-Hyun Baik, Yong Gyu Park, Seon Mee Kim, Nan Hee Kim, Kyung Mook Choi

Research output: Contribution to journalArticle

Abstract

Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes.We used the National Health Insurance Service, providing a population-based, nationwide database of Koreans. We included individuals without diabetes who underwent glucose measurement at least 3 times during 2002 to 2006. GV was calculated as standard deviation (SD) of fasting plasma glucose (FPG) levels. We observed development of CVD or all-cause death from 2007 to 2015, and also evaluated the mortality within 1 year after CVD.Among 3,211,319 people, we found 23,374 incident cases of myocardial infarction (MI), 27,705 cases of stroke, and 63,275 deaths during 8.3 years of follow-up. After multivariate adjustment, GV was found to be a significant predictor of MI, stroke and all-cause death for their highest quartile, with corresponding hazard ratios (HR) of 1.08 (95% confidence interval, CI 1.04-1.11), 1.09 (95% CI 1.06-1.13), and 1.12 (95% CI 1.10-1.15), respectively. The risk of death increased more in those who had both impaired fasting glucose and the highest quartile of GV (HR 1.24 [95% CI 1.21-1.28]). Moreover, early death rate after 1 year of CVD was higher in the highest quartile of GV compared to the lowest quartile (HR 1.21 [95% CI 1.03-1.41]).Long-term FPG variation was independently associated with CVD and mortality in a general population without diabetes.

Original languageEnglish
Pages (from-to)e16317
JournalMedicine
Volume98
Issue number29
DOIs
Publication statusPublished - 2019 Jul 1

Fingerprint

Cardiovascular Diseases
Mortality
Glucose
Fasting
Population
National Health Programs
Cause of Death
Stroke
Myocardial Infarction
Social Adjustment
Databases
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes : A nationwide population-based study. / Yu, Ji Hee; Han, Kyungdo; Park, Sanghyun; Lee, Da Young; Nam, Ga Eun; Seo, Ji A.; Kim, Sin Gon; Baik, Sei-Hyun; Park, Yong Gyu; Kim, Seon Mee; Kim, Nan Hee; Choi, Kyung Mook.

In: Medicine, Vol. 98, No. 29, 01.07.2019, p. e16317.

Research output: Contribution to journalArticle

Yu, Ji Hee ; Han, Kyungdo ; Park, Sanghyun ; Lee, Da Young ; Nam, Ga Eun ; Seo, Ji A. ; Kim, Sin Gon ; Baik, Sei-Hyun ; Park, Yong Gyu ; Kim, Seon Mee ; Kim, Nan Hee ; Choi, Kyung Mook. / Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes : A nationwide population-based study. In: Medicine. 2019 ; Vol. 98, No. 29. pp. e16317.
@article{6532d68161d0498082084206ff08868b,
title = "Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes: A nationwide population-based study",
abstract = "Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes.We used the National Health Insurance Service, providing a population-based, nationwide database of Koreans. We included individuals without diabetes who underwent glucose measurement at least 3 times during 2002 to 2006. GV was calculated as standard deviation (SD) of fasting plasma glucose (FPG) levels. We observed development of CVD or all-cause death from 2007 to 2015, and also evaluated the mortality within 1 year after CVD.Among 3,211,319 people, we found 23,374 incident cases of myocardial infarction (MI), 27,705 cases of stroke, and 63,275 deaths during 8.3 years of follow-up. After multivariate adjustment, GV was found to be a significant predictor of MI, stroke and all-cause death for their highest quartile, with corresponding hazard ratios (HR) of 1.08 (95{\%} confidence interval, CI 1.04-1.11), 1.09 (95{\%} CI 1.06-1.13), and 1.12 (95{\%} CI 1.10-1.15), respectively. The risk of death increased more in those who had both impaired fasting glucose and the highest quartile of GV (HR 1.24 [95{\%} CI 1.21-1.28]). Moreover, early death rate after 1 year of CVD was higher in the highest quartile of GV compared to the lowest quartile (HR 1.21 [95{\%} CI 1.03-1.41]).Long-term FPG variation was independently associated with CVD and mortality in a general population without diabetes.",
author = "Yu, {Ji Hee} and Kyungdo Han and Sanghyun Park and Lee, {Da Young} and Nam, {Ga Eun} and Seo, {Ji A.} and Kim, {Sin Gon} and Sei-Hyun Baik and Park, {Yong Gyu} and Kim, {Seon Mee} and Kim, {Nan Hee} and Choi, {Kyung Mook}",
year = "2019",
month = "7",
day = "1",
doi = "10.1097/MD.0000000000016317",
language = "English",
volume = "98",
pages = "e16317",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "29",

}

TY - JOUR

T1 - Effects of long-term glycemic variability on incident cardiovascular disease and mortality in subjects without diabetes

T2 - A nationwide population-based study

AU - Yu, Ji Hee

AU - Han, Kyungdo

AU - Park, Sanghyun

AU - Lee, Da Young

AU - Nam, Ga Eun

AU - Seo, Ji A.

AU - Kim, Sin Gon

AU - Baik, Sei-Hyun

AU - Park, Yong Gyu

AU - Kim, Seon Mee

AU - Kim, Nan Hee

AU - Choi, Kyung Mook

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes.We used the National Health Insurance Service, providing a population-based, nationwide database of Koreans. We included individuals without diabetes who underwent glucose measurement at least 3 times during 2002 to 2006. GV was calculated as standard deviation (SD) of fasting plasma glucose (FPG) levels. We observed development of CVD or all-cause death from 2007 to 2015, and also evaluated the mortality within 1 year after CVD.Among 3,211,319 people, we found 23,374 incident cases of myocardial infarction (MI), 27,705 cases of stroke, and 63,275 deaths during 8.3 years of follow-up. After multivariate adjustment, GV was found to be a significant predictor of MI, stroke and all-cause death for their highest quartile, with corresponding hazard ratios (HR) of 1.08 (95% confidence interval, CI 1.04-1.11), 1.09 (95% CI 1.06-1.13), and 1.12 (95% CI 1.10-1.15), respectively. The risk of death increased more in those who had both impaired fasting glucose and the highest quartile of GV (HR 1.24 [95% CI 1.21-1.28]). Moreover, early death rate after 1 year of CVD was higher in the highest quartile of GV compared to the lowest quartile (HR 1.21 [95% CI 1.03-1.41]).Long-term FPG variation was independently associated with CVD and mortality in a general population without diabetes.

AB - Increased glycemic variability (GV) is an independent risk factor for cardiovascular complications in patients with diabetes. We evaluated the risk of future development of cardiovascular disease (CVD) and death according to GV in a general population without diabetes.We used the National Health Insurance Service, providing a population-based, nationwide database of Koreans. We included individuals without diabetes who underwent glucose measurement at least 3 times during 2002 to 2006. GV was calculated as standard deviation (SD) of fasting plasma glucose (FPG) levels. We observed development of CVD or all-cause death from 2007 to 2015, and also evaluated the mortality within 1 year after CVD.Among 3,211,319 people, we found 23,374 incident cases of myocardial infarction (MI), 27,705 cases of stroke, and 63,275 deaths during 8.3 years of follow-up. After multivariate adjustment, GV was found to be a significant predictor of MI, stroke and all-cause death for their highest quartile, with corresponding hazard ratios (HR) of 1.08 (95% confidence interval, CI 1.04-1.11), 1.09 (95% CI 1.06-1.13), and 1.12 (95% CI 1.10-1.15), respectively. The risk of death increased more in those who had both impaired fasting glucose and the highest quartile of GV (HR 1.24 [95% CI 1.21-1.28]). Moreover, early death rate after 1 year of CVD was higher in the highest quartile of GV compared to the lowest quartile (HR 1.21 [95% CI 1.03-1.41]).Long-term FPG variation was independently associated with CVD and mortality in a general population without diabetes.

UR - http://www.scopus.com/inward/record.url?scp=85070496031&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070496031&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000016317

DO - 10.1097/MD.0000000000016317

M3 - Article

C2 - 31335679

AN - SCOPUS:85070496031

VL - 98

SP - e16317

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 29

ER -