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

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).

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).

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.

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.