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Multicenter Study
. 2025 Mar;17(3):e70065.
doi: 10.1111/1753-0407.70065.

Association of Glycaemia Risk Index With Indices of Atherosclerosis: A Cross-Sectional Study

Keiichi Torimoto  1 , Yosuke Okada  1   2 , Tomoya Mita  3 , Kenichi Tanaka  1 , Fumiya Sato  3 , Naoto Katakami  4 , Hidenori Yoshii  3 , Keiko Nishida  5 , Yoshiya Tanaka  1 , Ryota Ishii  6 , Masahiko Gosho  6 , Iichiro Shimomura  4 , Hirotaka Watada  3
Affiliations
Multicenter Study

Association of Glycaemia Risk Index With Indices of Atherosclerosis: A Cross-Sectional Study

Keiichi Torimoto et al. J Diabetes. 2025 Mar.

Erratum in

Abstract

Aims: This study determined the association of the glycaemia risk index (GRI), a novel comprehensive metric derived from continuous glucose monitoring (CGM), and atherosclerosis in patients with type 2 diabetes (T2DM).

Methods: We evaluated the relationship between GRI and intima-media thickness (IMT), gray-scale median (GSM), tissue characteristics of the carotid artery wall, and brachial-ankle pulse wave velocity (baPWV), using baseline data from a multicenter prospective cohort study of 1000 Japanese patients with T2DM free of cardiovascular disease (CVD).

Results: The study subjects were 999 patients (age: 64.6 ± 9.6 years, mean ± SD, 60.9% males, body mass index: 24.6 ± 3.9 kg/m2, HbA1c 7.1% ± 0.8%, TIR 78.9% ± 18.6%) with T2DM (duration of 12.9 ± 8.5 years). A higher GRI was associated with a longer duration of diabetes, a higher HbA1c level, a mean glucose level, and baPWV, and lower mean GSM. No association was noted between GRI and mean IMT. GRI was significantly associated with mean GSM (regression coefficient, β = -0.1277; 95% confidence interval: CI: -0.2165 to -0.0390, p = 0.005) and baPWV (regression coefficient, β = -3.1568; 95% CI: 1.5058 to 4.8079, p < 0.001) after adjustment for various cardiovascular risk factors.

Conclusions: GRI is a potentially useful predictor of atherosclerosis in patients with T2DM. Our findings suggest that GRI, a marker of the risk of hypoglycaemia and hyperglycaemia, may serve as a clinically useful tool for the assessment of the risk of CVD in patients with T2DM, independent of the classical cardiovascular risk factors.

Keywords: atherosclerosis; continuous glucose monitoring (CGM); flash glucose monitoring (FGM); glycaemia risk index (GRI); time in range (TIR); type 2 diabetes (T2DM).

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Relationship between GRI and indices of arteriosclerosis. (a) GRI in tertiles (Q1–Q3) of GSM. Q1: < 38.5 (n = 203), Q2: ≥ 38.5 to < 52.0 (n = 199), Q3: ≥ 52.0 (n = 197). (b) The GRI in tertiles (Q1–Q3) of thickened lesion‐GSM. Q1: < 33.0 (n = 186), Q2: ≥ 33.0 to < 50.0 (n = 194), Q3: ≥ 50.0 (n = 186). (c) The GRI in tertiles (Q1–Q3) of plaque‐GSM. Q1: < 46.0 (n = 163), Q2: ≥ 46.0 to < 67.0 (n = 158), Q3: ≥ 67.0 (n = 169). (d) The GRI in groups with [IMT‐thickness: IMT ≥ 1.0 mm (n = 28)], and without IMT‐thickening [IMT‐thickness: IMT < 1.0 mm (n = 572)]. (e) GRI of the high [baPWV ≥ 1800 cm/s (n = 149)] and low [baPWV < 1800 cm/s (n = 296)] arterial stiffness groups. baPWV, brachial‐ankle pulse wave velocity; GRI, glycaemia risk index; GSM, grayscale median; IMT, intima‐media thickness.
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