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      Trajectories of glycated hemoglobin of T2DM and progress of arterial stiffness: a prospective study

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          Abstract

          Aim

          This study aimed to describe the different trajectories groups of HbA1c during the long-term treatment of diabetes and explore the effect of glycemic control on the progression of arterial stiffness.

          Method

          The study participants registered at the National Metabolic Management Center (MMC) of Beijing Luhe hospital. The latent class mixture model (LCMM) was used to identify distinct trajectories of HbA1c. We calculated the change value of baPWV (ΔbaPWV) of each participant between the whole follow-up time as the primary outcome. Then we examined the associations between each HbA1c trajectory pattern and ΔbaPWV using covariate-adjusted means (SE) of ΔbaPWV, which were calculated by multiple linear regression analyses adjusted for the covariates.

          Results

          After data cleaning, a total of 940 type 2 diabetes patients aged 20–80 years were included in this study. According to the BIC, we identified four discrete trajectories of HbA1c: Low-stable, U-shape, Moderate-decrease, High-increase, respectively. Compared with the low-stable group of HbA1c, the adjusted mean values of baPWV were significantly higher in U-shape, Moderate-decrease, and High-increase groups (all P < 0.05, and P for trend < 0.001), the mean values (SE) were 82.73 (0.08), 91.19 (0.96), 116.00 (0.81) and 223.19 (11.54), respectively.

          Conclusion

          We found four different trajectories groups of HbA1c during the long-term treatment of diabetes. In addition, the result proves the causal relationship between long-term glycemic control and arterial stiffness on a time scale.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13098-023-01108-8.

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          Most cited references27

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          Group-based trajectory modeling in clinical research.

          Group-based trajectory models are increasingly being applied in clinical research to map the developmental course of symptoms and assess heterogeneity in response to clinical interventions. In this review, we provide a nontechnical overview of group-based trajectory and growth mixture modeling alongside a sampling of how these models have been applied in clinical research. We discuss the challenges associated with the application of both types of group-based models and propose a set of preliminary guidelines for applied researchers to follow when reporting model results. Future directions in group-based modeling applications are discussed, including the use of trajectory models to facilitate causal inference when random assignment to treatment condition is not possible.
            • Record: found
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            • Article: not found

            Large-Artery Stiffness in Health and Disease

            A healthy aorta exerts a powerful cushioning function, which limits arterial pulsatility and protects the microvasculature from potentially harmful fluctuations in pressure and blood flow. Large-artery (aortic) stiffening, which occurs with aging and various pathologic states, impairs this cushioning function, and has important consequences on cardiovascular health, including isolated systolic hypertension, excessive penetration of pulsatile energy into the microvasculature of target organs that operate at low vascular resistance, and abnormal ventricular-arterial interactions that promote left ventricular remodeling, dysfunction, and failure. Large-artery stiffness independently predicts cardiovascular risk and represents a high-priority therapeutic target to ameliorate the global burden of cardiovascular disease. This paper provides an overview of key physiologic and biophysical principles related to arterial stiffness, the impact of aortic stiffening on target organs, noninvasive methods for the measurement of arterial stiffness, mechanisms leading to aortic stiffening, therapeutic approaches to reduce it, and clinical applications of arterial stiffness measurements.
              • Record: found
              • Abstract: not found
              • Article: not found

              Estimation of Extended Mixed Models Using Latent Classes and Latent Processes: The R Package lcmm

                Author and article information

                Contributors
                likun@ccmu.edu.cn
                dor_caobin666@163.com
                280110535@qq.com
                lingbeiyangstudent@163.com
                zhaodong@ccmu.edu.cn
                Journal
                Diabetol Metab Syndr
                Diabetol Metab Syndr
                Diabetology & Metabolic Syndrome
                BioMed Central (London )
                1758-5996
                23 June 2023
                23 June 2023
                2023
                : 15
                : 135
                Affiliations
                [1 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Center for Endocrine Metabolism and Immune Diseases, , Beijing Luhe Hospital, Capital Medical University, ; Beijing, 101149 China
                [2 ]Beijing Key Laboratory of Diabetes Research and Care, Beijing, 101149 China
                Article
                1108
                10.1186/s13098-023-01108-8
                10288736
                37349777
                02d3e134-71ff-40da-9574-bdbca1a9b561
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 December 2022
                : 8 June 2023
                Funding
                Funded by: Tongzhou District Science and Technology project
                Award ID: No. KJ2022CX030
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2023

                Nutrition & Dietetics
                diabetes,hba1c,arterial stiffness,analysis of trajectory
                Nutrition & Dietetics
                diabetes, hba1c, arterial stiffness, analysis of trajectory

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