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Table 6 Results of multivariable analyses for the excess risks associated with 12- and 24-month glycemic variability parameters, divided into tertiles, for the occurrence of future diabetic microvascular complications

From: Long-term visit-to-visit glycemic variability as predictor of micro- and macrovascular complications in patients with type 2 diabetes: The Rio de Janeiro Type 2 Diabetes Cohort Study

Outcome

Glycemic parameter

12-month glycemic variability

24-month glycemic variability

Model 1

HR (95% CI)

Model 2

HR (95% CI)

Model 3

HR (95% CI)

Model 1

HR (95% CI)

Model 2

HR (95% CI)

Model 3

HR (95% CI)

Retinopathy (incident or worsening)

n = 152

FG-SD

2.78 (1.84–4.21)*

1.66 (1.04–2.65)‡

1.17 (0.69–1.98)

3.24 (2.14–4.92)*

1.89 (1.18–3.02)†

1.36 (0.79–2.33)

FG-VC

2.47 (1.64–3.71)*

1.50 (0.96–2.33)

1.31 (0.82–2.09)

2.47 (1.64–3.70)*

1.45 (0.93–2.25)

1.23 (0.77–1.96)

HbA1c-SD

2.59 (1.70–3.94)*

1.68 (1.07–2.64)‡

1.13 (0.66–1.95)

3.02 (1.96–4.65)*

2.01 (1.26–3.19)†

1.44 (0.84–2.46)

HbA1c-VC

2.03 (1.34–3.06)†

1.50 (0.98–2.31)

1.16 (0.74–1.84)

2.47 (1.62–3.76)*

1.82 (1.17–2.84)†

1.41 (0.88–2.26)

Composite renal outcome

n = 183

FG-SD

1.87 (1.29–2.71)†

1.52 (1.00–2.31)

1.32 (0.82–2.13)

2.18 (1.50–3.17)*

1.88 (1.23–2.87)†

1.66 (1.03–2.67)‡

FG-VC

1.69 (1.17–2.45)†

1.49 (0.99–2.22)

1.39 (0.91–2.12)

1.84 (1.28–2.66)†

1.66 (1.12–2.51)‡

1.60 (1.05–1.43)‡

HbA1c-SD

1.52 (1.06–2.17)‡

1.23 (0.84–1.81)

1.00 (0.62–1.59)

1.68 (1.18–2.39)†

1.38 (0.94–2.02)

1.14 (0.72–1.81)

HbA1c-VC

1.42 (1.00–2.02)‡

1.22 (0.85–1.76)

1.06 (0.72–1.58)

1.56 (1.10–2.21)‡

1.35 (0.93–1.94)

1.16 (0.79–1.72)

Microalbuminuria (incident)

n = 89

FG-SD

1.66 (0.98–2.81)

1.67 (0.93–2.98)

1.60 (0.81–3.13)

1.70 (1.00–2.90)‡

1.78 (0.98–3.22)

1.64 (0.81–3.33)

FG-VC

1.32 (0.78–2.25)

1.37 (0.77–2.42)

1.31 (0.73–2.37)

1.63 (0.96–2.78)

1.85 (1.03–3.30)‡

1.80 (0.98–3.30)

HbA1c-SD

1.10 (0.66–1.83)

1.04 (0.60–1.81)

0.80 (0.40–1.60)

1.31 (0.79–2.18)

1.28 (0.74–2.22)

1.06 (0.54–2.11)

HbA1c-VC

1.09 (0.65–1.81)

1.05 (0.62–1.79)

0.90 (0.50–1.63)

1.32 (0.79–2.19)

1.27 (0.74–2.19)

1.09 (0.59–2.01)

Renal failure

n = 91

FG-SD

2.70 (1.54–4.72)*

1.70 (0.90–3.20)

1.36 (0.67–2.77)

3.63 (2.05–6.45)*

2.14 (1.13–4.07)‡

1.75 (0.86–3.54)

FG-VC

2.56 (1.46–4.50)*

1.86 (1.01–3.44)‡

1.63 (0.86–3.08)

2.67 (1.56–4.59)*

1.71 (0.95–3.09)

1.57 (0.85–2.88)

HbA1c-SD

3.40 (1.95–5.92)*

2.34 (1.29–4.24)†

2.12 (1.05–4.27)‡

3.12 (1.82–5.37)*

2.13 (1.19–3.81)‡

1.78 (0.91–3.49)

HbA1c-VC

2.43 (1.43–4.11)*

1.91 (1.10–3.30)‡

1.66 (0.92–2.98)

2.38 (1.42–4.01)*

1.78 (1.03–3.08)‡

1.50 (0.84–2.67)

Peripheral neuropathy (incident or worsening)

n = 96

FG-SD

2.50 (1.35–4.62)†

1.45 (0.70–3.00)

1.05 (0.46–2.41)

2.82 (1.54–5.13)*

1.73 (0.85–3.50)

1.35 (0.60–3.03)

FG-VC

3.45 (1.77–6.72)*

2.52 (1.17–5.39)‡

2.02 (0.91–4.45)

3.60 (1.91–6.79)*

2.82 (1.36–5.87)†

2.33 (1.09–4.97)‡

HbA1c-SD

2.07 (1.16–3.77)‡

1.35 (0.69–2.68)

0.76 (0.33–1.75)

2.14 (1.18–3.90)‡

1.39 (0.70–2.77)

0.79 (0.34–1.79)

HbA1c-VC

1.82 (1.00–3.34)‡

1.34 (0.69–2.62)

0.97 (0.47–2.01)

2.38 (1.29–4.39)†

1.63 (0.83–3.22)

1.20 (0.57–2.50)

Peripheral neuropathy (incident)

n = 42

FG-SD

2.04 (0.90–4.62)

1.46 (0.54–3.95)

0.99 (0.31–3.16)

1.78 (0.80–3.97)

1.15 (0.44–2.99)

0.73 (0.24–2.25)

FG-VC

2.56 (1.07–6.13)‡

2.13 (0.78–5.81)

1.80 (0.64–5.07)

2.46 (1.05–5.78)‡

2.18 (0.83–5.72)

1.88 (0.69–5.13)

HbA1c-SD

2.17 (0.98–4.79)

1.55 (0.62–3.85)

1.07 (0.35–3.33)

2.21 (1.00–4.89)‡

1.59 (0.64–3.94)

1.15 (0.37–3.52)

HbA1c-VC

2.78 (1.16–6.67)‡

2.14 (0.82–5.58)

1.73 (0.61–4.94)

3.06 (1.28–7.23)‡

2.22 (0.86–5.75)

1.85 (0.66–5.18)

  1. Values are hazard ratios and 95% confidence intervals, estimated by Cox analyses, for the highest tertile subgroup in relation to the lowest one; except for peripheral neuropathy outcomes that are odds ratios and 95% confidence intervals, estimated by logistic regressions
  2. Models 1, 2 and 3 were adjusted for the same covariates as in Table 3, except for peripheral neuropathy that was adjusted for height instead of BMI and further for the time interval between baseline and second neuropathy examination
  3. HR hazard ratio, CI confidence interval, CV cardiovascular, FG-SD fasting glucose standard deviation, FG-VC fasting glucose variation coefficient, HbA 1c -SD glycated hemoglobin standard deviation, HbA 1c -VC glycated hemoglobin variation coefficient
  4. * p < 0.001; † p < 0.01; ‡ p < 0.05