Association Between the GMI/HbA1c Ratio and Microvascular Complications in Type 1 Diabetes: A Multicenter Cross-Sectional Study.
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Herranz-Antolín Sandra, Martínez-Brocca María Asunción, Cánovas-Molina Gloria, Aragón-Alonso Aurora, Brito-Sanfiel Miguel, Martínez-Montoro Jose Ignacio, Bellido Virginia, Azriel Sharona, López-García María Del Carmen, Tejera Cristina, Bartual Amparo, Perea Verónica, Pines Pedro José, Amor Antonio J, Moreno-Pérez Óscar, Reyes-García Rebeca, López-Gallardo Gema, Durán-Martínez María, Serrano Cristina, Márquez-Pardo Rosa, González-Pérez de Villar Noemí, Gargallo Manuel, Santos Estefanía, Pujante Pedro, Ares Jessica, Bellido Diego, Conget Ignacio, Gomez-Peralta Fernando
Аннотация
DESIGN AND METHODS: Multicentre, cross-sectional, observational study including subjects with T1D with at least 5 years of evolution, users of continuous glucose monitoring (CGM) with a coverage ≥ 80% 56 days prior to HbA1c. Logistic regression models were used to identify the factors independently associated with grouped microvascular complications and ocular disease.
RESULTS: As per data, 1315 participants were included. Patients were classified into tertiles based on the GMI/HbA1c ratio. High glycators were older than intermediate and low glycators (55.4 vs. 53.4 vs. 50.8 years; p < 0.001), respectively. Differences were also observed among the three groups with regard to average glucose (156.3 vs. 161.8 vs. 166.1 mg/dL; p < 0.001), time in range (66.3% vs. 62.9% vs. 59.9%; p < 0.001), time in tight range (42.9% vs. 39.9% vs. 37.1%; p < 0.001), coefficient of variation (34.5% vs. 34.9% vs. 35.6%; p = 0.023), GMI (7% vs. 7.2% vs. 7.3%; p < 0.001) and HbA1c (8.1% vs. 7.3% vs. 6.6%; p < 0.001). In the high glycators group, the prevalence of microvascular complications was higher than in the intermediate and low glycators (38.9% vs. 28.2% vs. 23.7%; p < 0.001), respectively. Also, the prevalence of ocular disease (31% vs. 20.2% vs. 19.7%; p < 0.001), nephropathy (14.9% vs. 8.3% vs. 6.2%; p < 0.001) and polyneuropathy (10.6% vs. 6.8% vs. 3.4%; p < 0.001) was higher in high glycators, The GMI/HbA1c ratio was significantly associated with the presence of grouped microvascular complications (OR 0.71; 95% CI: 0.61-0.81; p < 0.001) and ocular disease (OR 0.71; 95% CI: 0.61-0.82; p < 0.001) after adjusting for clinical ad glucometric variables.
CONCLUSIONS: The GMI/HbA1c ratio is associated with microvascular complications in this study. These results highlight the potential of this parameter in routine clinical practice for stratifying the risk of complications and for establishing individualized control goals and screening strategies.