Guangzhou, China: Study on Fasting Blood Sugar Variability and CAC Progression

Higher variability in fasting blood sugar in young adults may lead to greater coronary artery calcification (CAC) progression during middle age, finds a recent study in the journal Diabetes Care. This suggests its (fasting glucose variability) value in predicting risk for subclinical coronary artery diseases.

Glycemic variability (GV), which refers to swings in blood sugar levels, has a broader meaning because it alludes to blood sugar oscillations that occur throughout the day, including hypoglycemic periods and postprandial increases, as well as blood sugar fluctuations that occur at the same time on different days.

Weijing Feng, Southern Medical University, Guangzhou, China, and colleagues had investigated intraindividual variability of fasting blood sugar during young adulthood is associated with CAC progression in middle age.

The researchers included 2,256 participants from CARDIA (Coronary Artery Risk Development Study in Young Adults). CAC was assessed by computed tomography scanner at baseline (2000–2001) and 10 years later (2010–2011). Progression of CAC was assessed for each participant as the difference of logarithmic CAC scores at follow-up and baseline (log [CAC (follow-up) + 1] − log [CAC (baseline) + 1]).

FG variability was defined by the coefficient of variation about the mean FG (FG-CV), the SD of FG (FG-SD), and the average real variability of FG (FG-ARV) during 10-year follow-up. The researchers investigated the association between fasting blood sugar variability and CAC progression with adjustment for demographics, clinical risk factors, mean fasting blood sugar level, change in fasting blood sugar level, diabetes incidence, and medication use.

Key Findings of the Study

• After multivariable adjustment, 1-SD increment in FG-CV was associated with worse progression of CAC as demonstrated as percent change in CAC with incident CAC 5.9% and any CAC progression 6.7% during 10 years.
• Similar findings were also observed in FG-SD and FG-ARV.

"Higher FG variability during young adulthood was associated with greater CAC progression in middle age, suggesting its value in predicting risk for subclinical coronary artery diseases," concluded the authors.

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The study, "Association Between Fasting Glucose Variability in Young Adulthood and the Progression of Coronary Artery Calcification in Middle Age," is published in the journal Diabetes Care.

DOI: https://doi.org/10.2337/dc20-0838