BACKGROUND This study investigated whether visit-to-visit fasting plasma glucose (FPG) variability, as measured by the coefficient of variation (CV), increased peripheral artery disease (PAD) risk. METHODS Individuals with type 2 diabetes from the National Diabetes Care Management Program during the period 2002-2004, ≥ 30 years of age, and free of PAD (n = 30,932) were included and monitored until 2011. Cox proportional hazards regression models were implemented to analyze related determinants of PAD. RESULTS A total of 894 incident cases of PAD were identified during an average 8.2 years of follow-up, resulting in a crude incidence rate of 3.53 per 1000 person-years. Both FPG-CV and HbA1c were significantly associated with PAD after multivariate adjustment, with corresponding hazard ratios of 1.24 [95% confidence interval (CI) 1.04-1.47] for FPG-CV in the third tertile and 1.50 (95% CI 1.10-2.04) for HbA1c ≥ 10%. The findings of the sensitivity analysis remained consistent after excluding potential confounders, demonstrating the consistency of the results. CONCLUSIONS The associations between HbA1c, variability in FPG-CV, and PAD suggest a linked pathophysiological mechanism, suggesting the crucial role of glycemic variability in clinical management and therapeutic goals in preventing PAD in type 2 diabetes.

中文翻译：

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空腹血糖变化和HbA1c与2型糖尿病的外周动脉疾病风险相关。

背景技术这项研究调查了以变异系数（CV）衡量的访视空腹血糖（FPG）变异性是否增加了外周动脉疾病（PAD）的风险。方法纳入并监测直至2002年的美国国家糖尿病护理管理计划（National Diabetes Care Management Program）中≥30岁且无PAD（n = 30,932）的2型糖尿病患者，直至2011年。分析PAD的相关决定因素。结果在平均8.2年的随访期间，总共发现了894例PAD事件，导致每1000人年3.53的粗略发病率。多变量调整后，FPG-CV和HbA1c均与PAD显着相关，相应的危险比为1.24 [95％置信区间（CI）1.04-1。47]在第三三分位数中使用FPG-CV，HbA1c≥10％时使用1.50（95％CI 1.10-2.04）。排除潜在的混杂因素后，敏感性分析的结果保持一致，证明了结果的一致性。结论HbA1c，FPG-CV变异性和PAD之间的关联提示了一种相关的病理生理机制，表明血糖变异性在临床管理和预防2型糖尿病PAD的治疗目标中起着至关重要的作用。