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Background  The association of short‐term variability of fasting plasma glucose ( FPG ) and mortality has been well investigated. However, the relationships between visit‐to‐visit variability of  FPG  over longer periods of follow‐up and cardiovascular disease ( CVD ) and all‐cause mortality are unclear. This study aimed to investigate these relationships.    Methods and Results  The current analysis included 53 607 Chinese participants (mean age, 49.10 years) who were free of  CVD  in the Kailuan study. Participants were divided into 4 categories by quartiles of visit‐to‐visit variability of  FPG . Visit‐to‐visit variability of  FPG  was defined as the coefficient of variation of 3 values of  FPG  that were measured from the examination periods of 2006 to 2007, 2008 to 2009, and 2010 to 2011. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals for  CVD  and all‐cause mortality. After a mean follow‐up of 4.93 years, 4261 individuals developed  CVD  and 1545 individuals died. The incidence of  CVD  and all‐cause mortality was 5.04 and 5.85 per 1000 person‐years, respectively. After adjusting for mean  FPG  and other potential confounders, individuals in the highest quartile of variability of  FPG  compared with participants in the lowest quartile showed a 26% greater risk of developing  CVD  (hazard ratio, 1.26; 95% confidence interval, 1.08–1.47) and a 46% greater risk for all‐cause mortality (hazard ratio, 1.46; 95% confidence interval, 1.25–1.70).    Conclusions  Independent of mean  FPG  and other baseline parameters, elevated visit‐to‐visit variability of  FPG  significantly increases the risk of  CVD  and all‐cause mortality in the general population. Measuring long‐term visit‐to‐visit variability of  FPG  is helpful for predicting the risk for  CVD  and all‐cause mortality.

Visit‐to‐Visit Variability of Fasting Plasma Glucose and the Risk of Cardiovascular Disease and All‐Cause Mortality in the General Population