ArticleJournal of cachexia, sarcopenia and muscle2025
Dual Roles of HbA1c Variability and Body Composition for Cardiovascular Risk: A Cohort Study of 8224 Adults With Type 2 Diabetes Mellitus.
Article in Journal of cachexia, sarcopenia and muscle, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Glycemic variability of glycated hemoglobin in patients with type 2 diabetes mellitus and the risk of cardiovascular diseases: a latest systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Integrated Multi-Omics Analysis Identifies PDK4 and ACOT1 as Metabolic Hub Genes Associated With Myocardial Fibrosis in Diabetic Cardiomyopathy.Journal of diabetes research · 2026Article
- Dual Roles of HbA1c Variability and Body Composition for Cardiovascular Risk: A Cohort Study of 8224 Adults With Type 2 Diabetes Mellitus.Journal of cachexia, sarcopenia and muscle · 2025Article
- Predictors of response to anti-VEGF combined with laser therapy in severe non-proliferative diabetic retinopathy: development and validation of a nomogram model from retrospective data.Frontiers in endocrinology · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundGlycaemic variability and body composition are emerging predictors of cardiovascular disease (CVD) in patients with Type 2 diabetes mellitus (T2DM); however, their combined impact remains unclear. We investigated the association among HbA1c variability, body composition parameters and cardiovascular outcomes in adults with T2DM.
methodsThis retrospective cohort study analysed electronic health records from a university hospital (2011-2020), including 8224 adults (mean age 58.3 years, 50.1% women) with T2DM and no history of CVD. HbA1c variability score (HVS) was defined as the percentage of successive measurements differing by ≥ 0.5% (5.5 mmol/mol). Body composition was assessed by bioimpedance analysis. The primary outcome was incident CVD (ischemic heart disease, heart failure, atrial fibrillation, stroke, myocardial infarction).
resultsDuring median follow-up of 4.0 years, patients with high HVS (third tertile) showed significantly increased CVD risk compared to low HVS (first tertile) (adjusted hazard ratio [aHR] 1.70 [95% CI 1.13-2.40]; p < 0.010). HbA1c variability demonstrated superior cardiovascular risk prediction over fasting and postprandial glucose variability. Individuals with high HVS had significantly higher systolic blood pressure (122.72 ± 14.96 vs. 120.53 ± 14.52 mmHg, p = 0.017), HbA1c (7.72% ± 1.75% vs. 7.02% ± 1.09%, p < 0.001) and lower skeletal muscle mass (24.60 ± 5.73 vs. 25.85 ± 7.84 kg, p < 0.001). Higher appendicular skeletal muscle mass was protective against CVD (aHR 0.75 [95% CI 0.63-0.88]), while increased total fat percentage elevated CVD risk (aHR 1.10 [95% CI 1.03-1.20]). HVS correlated positively with changes in total fat percentage (β = 0.439, p < 0.001) and negatively with changes in relative appendicular skeletal muscle mass (β = -0.258, p < 0.001). In multivariate analysis, significant contributors to increased CVD risk included high HVS (aHR 1.65, p = 0.011), elevated average HbA1c (aHR 1.09, p = 0.016) and age over 65 years (aHR 1.61, p = 0.035).
conclusionsHbA1c variability and body composition independently predicted cardiovascular outcomes in patients with T2DM. Higher HbA1c variability increased CVD risk by 70%, while higher appendicular muscle mass reduced risk by 25%, and higher total fat percentage increased risk by 10%. Incorporating these parameters into risk stratification models could enhance cardiovascular risk prediction and guide preventive strategies for diabetes management.
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