Long-term glycemic variability and risk of peripheral artery disease: a systematic review and meta-analysis of cohort studies.

Jie Xia; Qionghui Peng; Lei Chen; Chiqiong Liu; Ting Zhu

doi:10.7717/peerj.21686

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Long-term glycemic variability and risk of peripheral artery disease: a systematic review and meta-analysis of cohort studies.

Jie Xia·Qionghui Peng·Lei Chen·Chiqiong Liu·Ting Zhu

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Abstract

BACKGROUND: A systematic review and meta-analysis to evaluate the impact of long-term glucose variability (GV) on the risk of developing peripheral artery disease (PAD). METHODS: The protocol was prospectively registered in PROSPERO (ID: CRD420251148763). Relevant longitudinal studies were identified through comprehensive searches of PubMed, Embase, and Web of Science. The primary outcome was the risk ratio (RR) of PAD comparing participants with high versus low GV. Summary effect sizes were calculated using a random-effects model to account for between-study heterogeneity. RESULTS: Eleven cohorts were included. Higher GV showed a positive association with PAD risk (RR: 1.42; 95% CI [1.21-1.66] p < 0.001), although substantial heterogeneity was present (I 2 = 91%). This association was consistent across subgroups defined by region (Asian vs. Western), study design, diabetic status, GV metrics, PAD diagnostic methods, and adjustment for HbA1c (all p for subgroup differences > 0.05), except for follow-up duration. Studies with follow-up < 8 years showed a stronger association than those with ≥ 8 years (RR: 1.64 vs. 1.19; p for subgroup difference = 0.006). CONCLUSIONS: Elevated long-term GV appears to be associated with an increased risk of PAD. However, substantial heterogeneity across studies suggests that the magnitude of this association should be interpreted with caution.

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Humans Peripheral Arterial Disease Blood Glucose Risk Factors Cohort Studies Glycemic variability Hyperglycemia Meta-analysis Peripheral artery disease Risk factor Systematic Review Journal Article Meta-Analysis

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Jie Xia, Qionghui Peng, Lei Chen, Chiqiong Liu, Ting Zhu. 2026-09-08. Long-term glycemic variability and risk of peripheral artery disease: a systematic review and meta-analysis of cohort studies.. https://doi.org/10.7717/peerj.21686

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Blood Glucose subject Cohort Studies subject Humans subject Journal Article subject Meta-Analysis subject Systematic reviews study glycemic variability subject

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