Glycated Haemoglobin A1c Variability Score Elicits Kidney Function Decline in Chinese People Living with Type 2 Diabetes

Yiling Zhou, Hongmei Huang, Xueqin Yan, Simona Hapca, Samira Bell, Furong Qu, Li Liu, Xiangyang Chen, Shengzhao Zhang, Qingyang Shi, Xiaoxi Zeng, Miye Wang, Nan Li, Heyue Du, Wentong Meng, Baihai Su, Haoming Tian, Sheyu Li (Lead / Corresponding author)

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Abstract

Our aim was to investigate the association of glycated haemoglobin A1c (HbA1c) variability score (HVS) with estimated glomerular filtration rate (eGFR) slope in Chinese adults living with type 2 diabetes. This cohort study included adults with type 2 diabetes attending outpatient clinics between 2011 and 2019 from a large electronic medical record-based database of diabetes in China (WECODe). We estimated the individual-level visit-to-visit HbA1c variability using HVS, a proportion of changes in HbA1c of ≥0.5% (5.5 mmol/mol). We estimated the odds of people experiencing a rapid eGFR annual decline using a logistic regression and differences across HVS categories in the mean eGFR slope using a mixed-effect model. The analysis involved 2397 individuals and a median follow-up of 4.7 years. Compared with people with HVS ≤ 20%, those with HVS of 60% to 80% had 11% higher odds of experiencing rapid eGFR annual decline, with an extra eGFR decline of 0.93 mL/min/1.73 m2 per year on average; those with HVS > 80% showed 26% higher odds of experiencing a rapid eGFR annual decline, with an extra decline of 1.83 mL/min/1.73 m2 per year on average. Chinese adults with type 2 diabetes and HVS > 60% could experience a more rapid eGFR decline.
Original languageEnglish
Article number6692
Number of pages11
JournalJournal of Clinical Medicine
Volume11
Issue number22
DOIs
Publication statusPublished - 11 Nov 2022

Keywords

  • HbA1c variability
  • eGFR slope
  • type 2 diabetes
  • kidney function decline
  • electronic medical records

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