Effect of fluctuation blood glucose level on arteriosclerosis in non-diabetic population

Objective　To investigate the effect of fluctuation of blood glucose level on arteriosclerosis in non-diabetic population. Methods　Subjects involved in an arteriosclerosis screening of annual physical examination in a Beijing community were studied. The glucose metabolic level of all the subjects was evaluated by 75g oral glucose tolerance test (OGTT), and the fluctuation of blood glucose level was assessed as the difference between 2h plasma glucose level and fasting plasma glucose (ΔPG) level. Brachial-ankle pulse wave velocity (baPWV) was examined to evaluate arteriosclerosis. The influence of glycemic variability and hemoglobin A1c (HbA1c) on arteriosclerosis was compared. Results　Six hundred and twenty non-diabetic subjects were involved in present study, and then were divided into quartiles based on ΔPG. The baPWV of Q4 (1431±325cm/s) was higher than that of Q1-Q3 groups (Q1-Q3: 1265±204, 1278±199 and 1307±200cm/s, P<0.01), and Q3 was higher than Q1 (P<0.05), while no statistical significance was found between Q1 and Q2. When the subjects were divided into quartiles based on HbA1c level, the baPWV of Q4 (1397±289cm/s) was higher than that of Q1-Q3 groups (Q1-Q3: 1276±200, 1290±212 and 1293±231cm/s, P<0.01), and no difference was found among Q1-Q3 groups. Monofactorial linear regression analysis revealed that both ΔPG (β=70.9, 95%CI 51.4-90.3, P<0.001) and HbA1c (β=137.4, 95%CI 82.1-192.6, P<0.001) were significantly correlated with baPWV. After multifactorial adjustment, multivariate linear regression analysis showed that only the glycemic variability (ΔPG model 1: β=21.4, P=0.009; model 2: β=14.9, P=0.045), but not HbA1c, was a significant risk factor of arteriosclerosis. Conclusion　Glycemic fluctuation is significantly correlated with baPWV, and is an influential factor of arteriosclerosis in non-diabetic population. DOI: 10.11855/j.issn.0577-7402.2013.12.12