JACC:处于糖尿病前期时就应该开始预防心血管和肾脏疾病!

2021-08-02 Nebula MedSci原创

糖尿病前期和2型糖尿病均与ASCVD、CKD和心衰相关

2型糖尿病是众所周知的与动脉粥样硬化性血管疾病(ASCVD)、慢性肾病(CKD)、心力衰竭和相关死亡率密切相关的风险因素。

目前针对糖尿病前期的治疗指南主要侧重于血糖控制和生活方式管理,很少有针对该人群的基于询证医学证据的心血管和肾脏疾病风险降低策略可用。

本研究旨在描绘不同血糖水平的个体的心血管和肾脏疾病结局。

纳入了英国生物库中无流行1型糖尿病、心血管疾病和肾脏疾病的个体。采用Cox模型检测血糖暴露(2型糖尿病、糖尿病前期、正常血糖)与各种疾病结局(ASCVD、CKD和心衰)的相关性,并根据地域、生活方式和心脏代谢风险因素进行校正。

不同血糖暴露水平个体的心血管事件发生情况

在336709位受试者(平均 56.3岁,55.4%的女性)中,46911位(13.9%)为糖尿病前期,12717位(3.8%)患有2型糖尿病。中位随访了11.1年后,6476位(13.8%)糖尿病前期受试者发生了≥1种本研究评估的疾病结局,其中只有802位(12.4%)在发生各种疾病结局前进展成了2型糖尿病。

根据血红蛋白水平分组的CKD、ASCVD和心力衰竭的发生情况

糖尿病前期和2型糖尿病都与ASCVD(糖尿病前期:校正风险比[aHR] 1.11,p<0.001;T2D:aHR 1.44,p<0.001)、CKD(aHR 1.08,p<0.001;aHR 1.57,p<0.001)和心力衰竭(aHR 1.07,p=0.03;aHR 1.35,p<0.001)独立相关。与糖化血红蛋白A1c(HbA1c)<5.0%相比,HbA1c高于5.4%、6.2%和7.0%时对应的的ASCVD、CKD和心力衰竭的共变量校正风险分别显著增加。

综上所述,糖尿病前期和2型糖尿病均与ASCVD、CKD和心衰相关,强调了加强干预策略以降低糖尿病前期个体的心血管和肾脏疾病风险的重要性和必要性。

原始出处:

Honigberg Michael C,Zekavat Seyedeh M,Pirruccello James P et al. Cardiovascular and Kidney Outcomes Across the Glycemic Spectrum: Insights From the UK Biobank.[J] .J Am Coll Cardiol, 2021, 78: 453-464.

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    2022-03-31 hbwxf
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    2021-08-02 misszhang

    谢谢MedSci提供最新的资讯

    0

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    2021-08-02 zy&kt

    👍,非常赞同!

    0

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    2021-08-02 北山布丁

    学习

    0

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