medwireNews: A prospective study has revealed that greater fasting glucose (FG) variability during young adulthood is independently associated with increased risk for coronary artery calcification (CAC) progression in middle age.
According to Minsheng Chen (Southern Medical University, Guangzhou, China) and fellow researchers, these results suggest that FG variability might be important in predicting risk for subclinical coronary artery diseases.
Using data from follow-up examinations from the CARDIA trial at years 15, 20, and 25, the team included 2256 participants, 2062 of whom had no CAC at year 15, which was considered the baseline for this study. At this time, participants were aged an average of approximately 40 years.
Chen et al note that individuals with CAC at baseline had faster CAC progression over the following 10 years than participants without baseline CAC.
When assessing FG variability using the coefficient of variation about the mean FG (FG-CV), the team found that FG variability was associated with a significantly increased risk for CAC progression during follow-up.
There was no significant difference in CAC at baseline across the different quartiles of FG-CV. However, Chen and co-workers explain that “CAC progression was gradually increased with quartiles of FG variability during 10-year follow-up.” At the 5-year and 10-year follow-ups, CAC progression was significantly greater among patients in the highest versus the lowest quartile for baseline FG-CV.
After multivariable adjustment accounting for factors including average FG and change in FG level during variability measurement, each standard deviation (SD) increment in FG-CV was associated with a 5.9% increased risk for incident CAC and a 6.7% increased risk for any CAC progression over 10 years.
The team notes that similar results were seen when FG variability was measured by the SD of FG (FG-SD) or the average real variability of FG (FG-ARV).
FG variability, as determined by FG‑CV, FG-SD, or FG-ARV, was more strongly associated with CAC progression in individuals without diabetes than in those with diabetes, the researchers highlight. However, they note that this outcome was possibly due “to the use of diabetes medication and the development of diabetes weakening the association between glycemic variability and CAC progression.”
Chen and team conclude in Diabetes Care that “[t]hese results suggest that efforts to achieve normal consistent levels of glucose very early in life may reduce the risk for future CAC and other subclinical coronary artery diseases.”
Diabetes Care 2020; doi:10.2337/dc20-0838
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