Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes

Abstract

Despite strenuous efforts to reduce cardiovascular disease (CVD) risk by improving cardiometabolic risk factors, such as glucose and cholesterol levels, and blood pressure, there is still residual risk even in patients reaching treatment targets. Recently, researchers have begun to focus on the variability of metabolic variables to remove residual risks. Several clinical trials and cohort studies have reported a relationship between the variability of metabolic parameters and CVDs. Herein, we review the literature regarding the effect of metabolic factor variability and CVD risk, and describe possible mechanisms and potential treatment perspectives for reducing cardiometabolic risk factor variability.

Keywords: Blood pressure; Body weight; Cholesterol; Gamma-glutamyltransferase; Glucose; Heart rate.

Fig. 1.

Potential pathogenesis of the adverse effects of glucose variability on cardiovascular risk. miRNA, microRNA; DM, diabetes mellitus; TNF-α, tumor necrosis factor-α; ICAM-1, intercellular adhesion molecule-1; ROS, reactive oxygen species; VEGF, vascular endothelial cell growth factor.

Fig. 2.

Evidence that previous studies have demonstrated on lipid variability-mediated cardiovascular complications, limitations of previous studies, and suggested directions for future studies. CVD, cardiovascular disease; VIM, variation independent of mean; SD, standard deviation; CV, coefficient of variation; ARV, average real variability.