AIM To evaluate the effect of mean HbA1c on the correlation between HbA1c variability and all-cause mortality, and the risks associated with different levels of HbA1c and glycaemic control status in patients with type 2 diabetes. MATERIALS AND METHODS Patients with type 2 diabetes and at least three HbA1c measurements within 12-24 months were included. HbA1c variability score, coefficient of variation (CV) and standard deviation (SD) were used to evaluate variability. A variability score of 50 was set as a cutoff to define low and high variability. RESULTS A total of 4216 patients were included, of whom 1196 died during the observation period (11.1 ± 3.2 years). All-cause mortality increased with HbA1c variability score and the quartiles of HbA1c CV and SD. The strength of this association was attenuated after adjustment for mean HbA1c, and the risks associated with HbA1c variability and glycaemic control status were similar. The highest associated risk was observed with an HbA1c variability score of >50 and mean HbA1c of ≥7.5%. Mortality risk was significantly higher with a mean HbA1c of ≤6.0% and >8.5% and of ≤6.0% and >8.0% for low and high HbA1c variability, respectively. CONCLUSIONS Mean HbA1c contributed to the correlation between HbA1c variability and all-cause mortality. The risks associated with HbA1c variability and glycaemic control status were similar. The relationship between mean HbA1c and mortality presented a J-shaped distribution for both low and high HbA1c variability.

中文翻译：

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平均HbA1c对2型糖尿病患者HbA1c变异性与全因死亡率的关联的影响。

目的评估平均H​​bA1c对2型糖尿病患者HbA1c变异性与全因死亡率之间的相关性以及与不同水平的HbA1c和血糖控制状态有关的风险。材料与方法纳入2型糖尿病患者，并在12-24个月内至少进行3次HbA1c测量。HbA1c变异性评分，变异系数（CV）和标准偏差（SD）用于评估变异性。将变异性得分设为50，以定义低变异性和高变异性。结果共纳入4216例患者，其中1196例在观察期内死亡（11.1±3.2年）。全因死亡率随HbA1c变异性评分以及HbA1c CV和SD的四分位数而增加。调整平均HbA1c后，该关联的强度减弱，与HbA1c变异性和血糖控制状态有关的风险相似。HbA1c变异评分> 50，平均HbA1c≥7.5％，观察到最高相关风险。低和高HbA1c变异性的平均HbA1c死亡率分别为≤6.0％和> 8.5％和≤6.0％和> 8.0％，死亡率风险显着更高。结论平均HbA1c有助于HbA1c变异性与全因死亡率之间的相关性。与HbA1c变异性和血糖控制状态有关的风险相似。平均HbA1c与死亡率之间的关系呈现出HbA1c的高低变异性呈J形分布。5％。低和高HbA1c变异性的平均HbA1c死亡率分别为≤6.0％和> 8.5％和≤6.0％和> 8.0％，死亡率风险显着更高。结论平均HbA1c有助于HbA1c变异性与全因死亡率之间的相关性。与HbA1c变异性和血糖控制状态有关的风险相似。平均HbA1c与死亡率之间的关系呈现出HbA1c的高低变异性呈J形分布。5％。低和高HbA1c变异性的平均HbA1c死亡率分别为≤6.0％和> 8.5％和≤6.0％和> 8.0％，死亡率风险显着更高。结论平均HbA1c有助于HbA1c变异性与全因死亡率之间的相关性。与HbA1c变异性和血糖控制状态有关的风险相似。平均HbA1c与死亡率之间的关系呈现出HbA1c的高低变异性呈J形分布。