Correlation between long-term fasting blood glucose variability and severity of coronary artery lesions in elderly male patients with coronary heart disease

  Background   The gold standard for diagnosis of coronary heart disease is coronary angiography (CAG), and previous studies have found that there is a correlation between short-term glycemic variability and severity of coronary artery lesions, while similar research in terms of long-term glycemic variability is rare.

  Objective   To investigate the relationship between long-term fasting blood glucose (FBG) variability and severity of coronary artery lesions in elderly male patients with coronary heart disease (CHD).

  Methods   A total of 140 inpatients underwent CAG in the Second Medical Center of Chinese PLA General Hospital from August 2009 to October 2020 were enrolled and divided into group A (Gensini score≥30 points, n=67) and group B (Gensini score ＜30 points, n=73) according to their CAG reports. Multivariate logistic binary regression analysis was used to determine the independent risk factors of severe lesions. And the correlation between severity of their coronary artery lesions and long-term FBG variability including the standard deviation, the coefficient of variation and the average successive values was analyzed.

  Results   SD_FBG, CV_FBG and ASV_FBG were all positively correlated with severity of lesions in elderly men with CHD (SD_FBG: HR: 2.274 95% CI: 1.175-4.401, P=0.015; CV_FBG: HR: 1.057 95% CI: 1.005-1.111, P=0.032; ASV_FBG: HR: 1.924 95% CI: 1.047-3.536, P=0.035). When long-term FBG variability was analyzed as a ordinal variable, compared with low SD_FBG (＜0.35 mmol/L) group, participants with high or median SD_FBG (＞0.59 mmol/L, 0.35-0.59 mmol/L) had a significantly higher risk for severe lesions of coronary artery, which were 2.631 times (95% CI: 1.109-6.241, P=0.028) and 2.473 times (95% CI: 1.037-5.900, P=0.041), respectively. While the same risk in patients with high CV_FBG (＞10.40%) was 2.399 times (95% CI : 1.019-5.645, P=0.045) compared to low CV_FBG (＜6.61%) patients. There was no obvious difference between median CV_FBG (6.61-10.40%) group and low CV_FBG group in terms of severity lesions, the same as risk in high or median ASV_FBG (＞0.61 mmol/L, 0.41-0.61 mmol/L) group compared with low ASV_FBG (＜0.41mmol/L) group. Conclusion There exists positive correlation between long-term fasting blood glucose variability and severity of coronary artery lesions in elderly male patients with CHD.