Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches

Abstract Background This study aimed to examine the associations between visit-to-visit variability in fasting plasma glucose (FPG) and HbA1c with echocardiographic variables in patients with type 2 diabetes using epidemiologic and Mendelian randomization (MR) methods. Methods From January 2001 to D...

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Main Authors: Cheng-Chieh Lin, Chia-Ing Li, Chiu-Shong Liu, Chih-Hsueh Lin, Shing-Yu Yang, Tsai-Chung Li
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Diabetology & Metabolic Syndrome
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Online Access:https://doi.org/10.1186/s13098-025-01728-2
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author Cheng-Chieh Lin
Chia-Ing Li
Chiu-Shong Liu
Chih-Hsueh Lin
Shing-Yu Yang
Tsai-Chung Li
author_facet Cheng-Chieh Lin
Chia-Ing Li
Chiu-Shong Liu
Chih-Hsueh Lin
Shing-Yu Yang
Tsai-Chung Li
author_sort Cheng-Chieh Lin
collection DOAJ
description Abstract Background This study aimed to examine the associations between visit-to-visit variability in fasting plasma glucose (FPG) and HbA1c with echocardiographic variables in patients with type 2 diabetes using epidemiologic and Mendelian randomization (MR) methods. Methods From January 2001 to December 2020, 2,326 (1,233 men and 1,093 women) subjects with type 2 diabetes who underwent echocardiography assessment were enrolled in the diabetes care management program of a medical center in Taiwan. The echocardiographic variables included those for cardiac structural, cardiac systolic, and diastolic function. Variability in FPG and HbA1c within one-year prior echocardiographic measurements was calculated using coefficient of variation (CV). A two-stage multivariable regression analysis was used to assess the causal relationship among FPG-CV, HbA1c-CV, and echocardiographic variables using 22 SNPs for FPG and 14 SNPs for HbA1c as instrumental variables. Results A total of 2,326 participants were included, with a mean age of 64.5 years and 53.0% were men. Epidemiologic and MR analyses show the significant associations between left atrium diameter (LAD), left ventricular systolic diameter (LVSd), left ventricular mass (LVM), left ventricular ejection fraction (LVEF), E, and E/e’ ratio with FPG variability. Significant associations between HbA1c variability and echocardiographic variables including LAD, E/e’, and deceleration time identified in the epidemiologic approach became non-significant in the MR analysis when controlling for covariates. Conclusions Our epidemiologic and MR studies demonstrated that visit-to-visit variability of FPG in patients with type 2 diabetes was independently associated with the left cardiac structure as well as systolic and diastolic function.
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spelling doaj-art-cd07530bdebd45ec98cb1fbcae17de1d2025-08-20T03:48:15ZengBMCDiabetology & Metabolic Syndrome1758-59962025-05-0117111210.1186/s13098-025-01728-2Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approachesCheng-Chieh Lin0Chia-Ing Li1Chiu-Shong Liu2Chih-Hsueh Lin3Shing-Yu Yang4Tsai-Chung Li5School of Medicine, College of Medicine, China Medical UniversitySchool of Medicine, College of Medicine, China Medical UniversitySchool of Medicine, College of Medicine, China Medical UniversitySchool of Medicine, College of Medicine, China Medical UniversityDepartment of Public Health, College of Public Health, China Medical UniversityDepartment of Public Health, College of Public Health, China Medical UniversityAbstract Background This study aimed to examine the associations between visit-to-visit variability in fasting plasma glucose (FPG) and HbA1c with echocardiographic variables in patients with type 2 diabetes using epidemiologic and Mendelian randomization (MR) methods. Methods From January 2001 to December 2020, 2,326 (1,233 men and 1,093 women) subjects with type 2 diabetes who underwent echocardiography assessment were enrolled in the diabetes care management program of a medical center in Taiwan. The echocardiographic variables included those for cardiac structural, cardiac systolic, and diastolic function. Variability in FPG and HbA1c within one-year prior echocardiographic measurements was calculated using coefficient of variation (CV). A two-stage multivariable regression analysis was used to assess the causal relationship among FPG-CV, HbA1c-CV, and echocardiographic variables using 22 SNPs for FPG and 14 SNPs for HbA1c as instrumental variables. Results A total of 2,326 participants were included, with a mean age of 64.5 years and 53.0% were men. Epidemiologic and MR analyses show the significant associations between left atrium diameter (LAD), left ventricular systolic diameter (LVSd), left ventricular mass (LVM), left ventricular ejection fraction (LVEF), E, and E/e’ ratio with FPG variability. Significant associations between HbA1c variability and echocardiographic variables including LAD, E/e’, and deceleration time identified in the epidemiologic approach became non-significant in the MR analysis when controlling for covariates. Conclusions Our epidemiologic and MR studies demonstrated that visit-to-visit variability of FPG in patients with type 2 diabetes was independently associated with the left cardiac structure as well as systolic and diastolic function.https://doi.org/10.1186/s13098-025-01728-2Type 2 diabetesEchocardiographyMendelian randomizationGlucose variability
spellingShingle Cheng-Chieh Lin
Chia-Ing Li
Chiu-Shong Liu
Chih-Hsueh Lin
Shing-Yu Yang
Tsai-Chung Li
Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches
Diabetology & Metabolic Syndrome
Type 2 diabetes
Echocardiography
Mendelian randomization
Glucose variability
title Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches
title_full Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches
title_fullStr Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches
title_full_unstemmed Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches
title_short Visit-to-visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes: epidemiological and mendelian randomization approaches
title_sort visit to visit glucose variability is associated with echocardiographic variables in people with type 2 diabetes epidemiological and mendelian randomization approaches
topic Type 2 diabetes
Echocardiography
Mendelian randomization
Glucose variability
url https://doi.org/10.1186/s13098-025-01728-2
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