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

作者：Chengsi Wu, Aijing Li, Qingyi Zhu, Jingyi Guo, Yiying Li, Xin Gu, Anning Sun, Maoying Wei, Yanbing Gong · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1698360 · 被引用次数：6 · 研究领域：Advanced Glycation End Products research、Diabetes, Cardiovascular Risks, and Lipoproteins、Diabetes Treatment and Management

Objective: Glycated hemoglobin (HbA1c) variability is a crucial indicator for evaluating the stability of long-term glycemic control in patients with diabetes mellitus. This study aimed to clarify the association between HbA1c variability and the risk of incident cardiovascular disease (CVD) and mortality in patients with type 2 diabetes mellitus (T2DM) through a systematic review, thereby providing evidence-based support for the early prevention of adverse cardiovascular events in T2DM patients. Methods: We systematically searched the PubMed, Web of Science, The Cochrane Library, and Embase databases for studies on the association between HbA1c variability and cardiovascular outcomes in patients with T2DM, published from the establishment of each database up to August 5, 2025. Cardiovascular outcomes included the incidence of CVD and CVD-related mortality. Two researchers independently conducted literature screening, data extraction, and risk of bias assessment. Meta-analysis was performed using Review Manager 5.3 software, with hazard ratio (HR) or odds ratio (OR) as the effect size. Results: A total of 31 cohort studies were included, covering 545,956 participants from 13 countries and regions. The results of the meta-analysis showed that a higher coefficient of variation (CV) of HbA1c was significantly associated with an increased risk of cardiovascular events (HR = 1.32, 95% CI: 1.18-1.49, P < 0.00001; OR = 1.39, 95% CI: 1.22-1.57, P < 0.00001), and also significantly el...