Predictive Ability of Visit-to-Visit Variability of HbA1c Measurements for the Development of Diabetic Kidney Disease: A Retrospective Longitudinal Observational Study. (22nd January 2022)

• Record Type: Journal Article
• Authors: Yan, Yunyi; Kondo, Nozomi; Oniki, Kentaro; Watanabe, Hiroshi; Imafuku, Tadashi; Sakamoto, Yuki; Shigaki, Takuro; Maruyama, Akari; Nakazawa, Hitomi; Kaneko, Tetsuya; Morita, Ayami; Yoshida, Akira; Maeda, Hitoshi; Maruyama, Toru; Jinnouchi, Hideaki; Saruwatari, Junji
• Other Names: Migdalis Ilias Academic Editor.
• Is Part Of: Journal of diabetes research. Volume 2022(2022)
• Publication Date: 2022-01-22
• Subjects: Diabetes -- Periodicals; Diabetes -- Pathophysiology -- Periodicals; Diabetes -- Prevention -- Periodicals; Diabetes -- Etiology -- Periodicals; Diabetes -- Epidemiology -- Periodicals; Diabetes -- Pathogenesis -- Periodicals; 616.462005
• DOI: 10.1155/2022/6934188
• Languages: English
• ISSNs: 2314-6745

Abstract

Abstract : Aims . This study is aimed at clarifying the relationship between visit-to-visit variability of glycated hemoglobin (HbA1c) and the risk of diabetic kidney disease (DKD) and to identifying the most useful index of visit-to-visit variability of HbA1c. Methods . This clinic-based retrospective longitudinal study included 699 Japanese type 2 diabetes mellitus patients. Visit-to-visit variability of HbA1c was calculated as the internal standard deviation of HbA1c (HbA1c-SD), the coefficient of variation of HbA1c (HbA1c-CV), the HbA1c change score (HbA1c-HVS), and the area under the HbA1c curve (HbA1c-AUC) with 3-year serial HbA1c measurement data, and the associations between these indices and the development/progression of DKD were examined. Results . Cox proportional hazards models showed that the HbA1c-SD and HbA1c-AUC were associated with the incidence of microalbuminuria, independently of the HbA1c level. These results were verified and replicated in propensity score (PS) matching and bootstrap analyses. Moreover, the HbA1c-SD and HbA1c-AUC were also associated with oxidized human serum albumin (HSA), an oxidative stress marker. Conclusions . Visit-to-visit variability of HbA1c was an independent risk factor of microalbuminuria in association with oxidative stress among type 2 diabetes mellitus patients. HbA1c-AUC, a novel index of HbA1c variability, may be a potent prognostic indicator in predicting the risk of microalbuminuria.