Cardiovasc Diabetol:血脂变异性对2型糖尿病患者死亡率的影响

2021-11-26 Nebula MedSci原创

血脂变异与 2 型糖尿病患者的全因死亡率和心血管死亡率密切相关

在过去的 30 年中,糖尿病的患病率大幅增加,这种情况给医疗保健系统造成了巨大负担。糖尿病使心血管疾病 (CVD) 的风险平均增加两倍,糖尿病发病越早,死亡率越高,这主要归因于心血管疾病死亡率。

血脂异常是主要的心血管危险因素,常见于糖尿病患者。大多数指南都关注最佳血脂水平,而很少讨论血脂谱的变化。本研究旨在调查血脂的访访间变异性与 2 型糖尿病患者的全因、心血管和非心血管死亡率之间的关联。

研究人员共筛选了 10583 位 30 岁及以上参与糖尿病管理计划的 2 型糖尿病患者,随访了 3 年及以上。使用变异系数计算进入管理计划后 3 年内的脂质谱的变异性。

血脂变异性与死亡风险比的相关性

平均随访了 6.4 年后,共记录了 1838 例全因死亡(包括 809 例心血管死亡)。高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和总胆固醇的变异性每增加 10%,全因死亡的风险比分别是 1.30(95% CI 1.22-1.37)、1.05 (1.01-1.09) 和 1.10 (1.03-1.16);心血管死亡的风险比分别是 1.27 (1.16-1.39)、1.08 (1.02-1.15) 和 1.16 (1.07-1.27)。

高密度脂蛋白胆固醇的变异性每增加 10%,非心血管死亡风险就会增加 31%。总胆固醇和低密度脂蛋白胆固醇的高变异性增加了不吸烟、定期锻炼、非血脂异常和更严重的糖尿病亚组个体的全因死亡率。

综上所述,除甘油三酯变异外,血脂变异与 2 型糖尿病患者的全因死亡率和心血管死亡率密切相关

原始出处:

Wang, MC., Li, CI., Liu, CS. et al. Effect of blood lipid variability on mortality in patients with type 2 diabetes: a large single-center cohort study. Cardiovasc Diabetol 20, 228 (2021). https://doi.org/10.1186/s12933-021-01421-4

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    2022-01-10 quxin068
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encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Jan 23 10:03:57 CST 2022, time=2022-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075722, encodeId=361510e57226e, content=两者总是相关,但又不算强关, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02652902302, createdName=414104166, createdTime=Wed Dec 01 08:03:55 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075387, encodeId=883710e538785, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a44885671, createdName=419040982, createdTime=Tue Nov 30 10:55:46 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075133, encodeId=477210e51335a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIr5qh5IzgYO6UIFdA4b1Y8yTH1jYxgXiaMujLELJliaNgibvKeRCjSHtctHib7lvvFQaH0ktrpv1EKsg/132, createdBy=e73e5262679, createdName=curry1989, createdTime=Mon Nov 29 17:50:05 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075115, encodeId=21cb10e511569, content=好文章,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=15875242542, createdName=147c3b86m51暂无昵称, 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  5. 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createdName=419040982, createdTime=Tue Nov 30 10:55:46 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075133, encodeId=477210e51335a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIr5qh5IzgYO6UIFdA4b1Y8yTH1jYxgXiaMujLELJliaNgibvKeRCjSHtctHib7lvvFQaH0ktrpv1EKsg/132, createdBy=e73e5262679, createdName=curry1989, createdTime=Mon Nov 29 17:50:05 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075115, encodeId=21cb10e511569, content=好文章,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=15875242542, createdName=147c3b86m51暂无昵称, createdTime=Mon Nov 29 16:55:36 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074994, encodeId=980210e49946f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211126/ed525419364c40fabe9c492f1ab14454/f2d7e053250e42978439ecba216fc77c.jpg, createdBy=2e465079378, createdName=ada昵称, createdTime=Mon Nov 29 10:03:21 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342927, encodeId=108b134292ee7, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun Nov 28 14:03:57 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
    2021-12-01 414104166

    两者总是相关,但又不算强关

    0

  6. 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encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Jan 23 10:03:57 CST 2022, time=2022-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075722, encodeId=361510e57226e, content=两者总是相关,但又不算强关, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=02652902302, createdName=414104166, createdTime=Wed Dec 01 08:03:55 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075387, encodeId=883710e538785, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a44885671, createdName=419040982, createdTime=Tue Nov 30 10:55:46 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075133, encodeId=477210e51335a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIr5qh5IzgYO6UIFdA4b1Y8yTH1jYxgXiaMujLELJliaNgibvKeRCjSHtctHib7lvvFQaH0ktrpv1EKsg/132, createdBy=e73e5262679, createdName=curry1989, createdTime=Mon Nov 29 17:50:05 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075115, encodeId=21cb10e511569, content=好文章,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=15875242542, createdName=147c3b86m51暂无昵称, createdTime=Mon Nov 29 16:55:36 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074994, encodeId=980210e49946f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211126/ed525419364c40fabe9c492f1ab14454/f2d7e053250e42978439ecba216fc77c.jpg, createdBy=2e465079378, createdName=ada昵称, createdTime=Mon Nov 29 10:03:21 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342927, encodeId=108b134292ee7, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun Nov 28 14:03:57 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
    2021-11-30 419040982

    好文章!

    0

  7. 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createdName=419040982, createdTime=Tue Nov 30 10:55:46 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075133, encodeId=477210e51335a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIr5qh5IzgYO6UIFdA4b1Y8yTH1jYxgXiaMujLELJliaNgibvKeRCjSHtctHib7lvvFQaH0ktrpv1EKsg/132, createdBy=e73e5262679, createdName=curry1989, createdTime=Mon Nov 29 17:50:05 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075115, encodeId=21cb10e511569, content=好文章,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=15875242542, createdName=147c3b86m51暂无昵称, createdTime=Mon Nov 29 16:55:36 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074994, encodeId=980210e49946f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211126/ed525419364c40fabe9c492f1ab14454/f2d7e053250e42978439ecba216fc77c.jpg, createdBy=2e465079378, createdName=ada昵称, createdTime=Mon Nov 29 10:03:21 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342927, encodeId=108b134292ee7, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun Nov 28 14:03:57 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
    2021-11-29 curry1989

    已读

    0

  8. 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createdName=419040982, createdTime=Tue Nov 30 10:55:46 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075133, encodeId=477210e51335a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIr5qh5IzgYO6UIFdA4b1Y8yTH1jYxgXiaMujLELJliaNgibvKeRCjSHtctHib7lvvFQaH0ktrpv1EKsg/132, createdBy=e73e5262679, createdName=curry1989, createdTime=Mon Nov 29 17:50:05 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075115, encodeId=21cb10e511569, content=好文章,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=15875242542, createdName=147c3b86m51暂无昵称, createdTime=Mon Nov 29 16:55:36 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074994, encodeId=980210e49946f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211126/ed525419364c40fabe9c492f1ab14454/f2d7e053250e42978439ecba216fc77c.jpg, createdBy=2e465079378, createdName=ada昵称, createdTime=Mon Nov 29 10:03:21 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342927, encodeId=108b134292ee7, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78c32500188, createdName=12498dabm77暂无昵称, createdTime=Sun Nov 28 14:03:57 CST 2021, time=2021-11-28, status=1, ipAttribution=)]
    2021-11-29 147c3b86m51暂无昵称

    好文章,值得学习

    0

  9. 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createdName=419040982, createdTime=Tue Nov 30 10:55:46 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075133, encodeId=477210e51335a, content=已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIr5qh5IzgYO6UIFdA4b1Y8yTH1jYxgXiaMujLELJliaNgibvKeRCjSHtctHib7lvvFQaH0ktrpv1EKsg/132, createdBy=e73e5262679, createdName=curry1989, createdTime=Mon Nov 29 17:50:05 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075115, encodeId=21cb10e511569, content=好文章,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=15875242542, createdName=147c3b86m51暂无昵称, createdTime=Mon Nov 29 16:55:36 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1074994, encodeId=980210e49946f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211126/ed525419364c40fabe9c492f1ab14454/f2d7e053250e42978439ecba216fc77c.jpg, createdBy=2e465079378, createdName=ada昵称, createdTime=Mon Nov 29 10:03:21 CST 2021, time=2021-11-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1342927, encodeId=108b134292ee7, content=<a href='/topic/show?id=34cb381023e' target=_blank style='color:#2F92EE;'>#变异#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38102, encryptionId=34cb381023e, topicName=变异)], attachment=null, authenticateStatus=null, 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    2021-11-29 ada昵称

    学习

    0

  10. 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