Purpose: The objective of this study was to investigate the association of abnormal glycemic phenotypes with microvascular complications in type 2 diabetes patients.
Participants and Methods: A total of 24,266 participants who were from the multicenter cross-sectional survey of China National HbA1c Surveillance System across China were included in the present study. Diabetes patients with abnormal glucose were divided into three groups according to phenotype: isolated fasting hyperglycemia (IFH), isolated postprandial hyperglycemia (IPH), or combined hyperglycemia (CH). The main outcomes were isolated diabetic retinopathy, isolated diabetic nephropathy, and combined diabetic retinopathy with nephropathy. Multivariate logistic regression was used to assess the association of abnormal glycemic phenotypes with microvascular complications.
Results: The CH phenotype had the highest prevalence of isolated diabetic retinopathy, isolated diabetic nephropathy and combined diabetic retinopathy with nephropathy, followed by IPH. Multivariate analysis showed that the CH phenotype was associated with the highest risk of isolated diabetic retinopathy (OR: 1.20, 95% CI: 1.02– 1.41), isolated diabetic nephropathy (OR: 1.59, 95% CI: 1.27– 2.01) and combined diabetic retinopathy with nephropathy (OR: 1.93, 95% CI: 1.44– 2.59). More importantly, participants with IPH phenotype also showed significantly higher risks of isolated diabetic retinopathy (OR: 1.16, 95% CI: 1.05– 1.28), isolated diabetic nephropathy (OR: 1.37, 95% CI: 1.09– 1.37) and combined diabetic retinopathy with nephropathy (OR:1.64, 95% CI: 1.21– 2.21) compared to the IFH phenotype. After stratifying by age, sex, diabetes duration and BMI, the higher risks of isolated diabetic retinopathy, isolated diabetic nephropathy and combined diabetic retinopathy with nephropathy were confirmed in IPH phenotype group, compared to the IFH phenotype group.
Conclusion: Diabetic patients with IPH phenotype had higher risks of isolated diabetic retinopathy, isolated diabetic nephropathy and combined diabetic retinopathy with nephropathy compared with the participants phenotype of IFH, but lower than the phenotype of CH.
Keywords: abnormal glycemic phenotype, diabetic nephropathy, diabetic retinopathy, type 2 diabetes mellitus