Visit-to-Visit Variability in Fasting Blood Glucose Predicts the New-Onset Heart Failure: Results From Two Large Chinese Cohorts

Previous studies have hypothesized an asso-ciation between higher fasting blood glucose (FBG) and heart failure (HF). However, FBG values fluctuate continuously over time, the association between FBG variability and the risk of HF is uncertain. We investi-gated the relationship between visit-to-visit variability in FBG and the risk of new-onset HF. This cohort study used data from a prospective Kailuan cohort (recruited during 2006-2007) and a retrospective cohort of family medicine patients from Hong Kong (recruited during 2000-2003) were followed up until December 31st, 2016, and December 31st, 2019, respectively, for the outcome of incident HF. Four indexes of variability were used, including standard deviation (SD), coefficient of variation (CV), variabil- ity independent of the mean (VIM), and average real variability (ARV). Cox regression was used to identify HF. In total, 98,554 and 22,217 subjects without preex- isting HF from the Kailuan and Hong Kong cohorts were analyzed, respectively, with 1218 cases of inci- dent HF in the former and 4,041 in the latter. Subjects in the highest quartile of FBG-CV had the highest risk of incident HF in both cohorts (Kailuan: HR 1.245, 95% CI 1.055-1.470); Hong Kong: HR 1.362, 95%CI 1.145-1.620; compared with the lowest quartile). Simi- lar results were observed when using FBG-ARV, FBG-VIM, and FBG-SD. Meta-analysis showed simi- lar results (highest versus lowest quartile: HR 1.30, 95%CI 1.15-1.47, P < 0.0001). As observed from 2 large, geographically distinct Chinese cohorts, a higher FBG variability was independently associated with higher risk of incident HF. (Curr Probl Cardiol 2023;48:101842.)

Automated summary

A higher variability in fasting blood glucose is independently associated with an increased risk of heart failure, according to a study conducted on two large Chinese cohorts.