Diabetes Care:2型糖尿病患者HbA1c变异性与心血管疾病和微血管并发症有关

2019-11-15 xing.T MedSci原创

由此可见,该研究表明较高的HbA1c变异性与全因死亡率、心血管事件和糖尿病微血管并发症的风险增加有关,并且独立于HbA1c。

近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,该研究旨在探讨新诊断2型糖尿病患者HbA1c变异性与心血管事件和微血管并发症之间的关系。

这项回顾性队列研究分析了苏格兰护理信息-糖尿病合作组织(SCI-DC)试验来自泰赛德和法夫的患者,这些参与者可观察到糖尿病诊断并且在评估结局之前至少进行了五次HbA1c测量。研究人员使用先前报告的HbA1c变异性评分(HVS),计算个体中所有HbA1c测量值中HbA1c>0.5%(5.5mmol/mol)变化数量的百分比。研究人员使用Cox比例风险模型评估了HVS与10个预后之间的关联。

研究人员在每个预后分析中纳入了13111–19883名患者。与最低的五分位数相比,HVS>60%的患者的所有结局风险均较高(例如,[80<HVS≤100与0<HVS≤20]的风险比和95%CI:对于主要不良心血管事件为2.38[1.61-3.53],对于全因死亡率为2.4 [1.72-3.33],对于动脉粥样硬化性心血管死亡为2.4 [1.13-5.11],对于冠状动脉疾病为2.63 [1.81-3.84],对于缺血性卒中2.04 [1.12-3.73],对于心力衰竭为3.23 [1.76-5.93],对于糖尿病性视网膜病变为7.4 [3.84–14.27],对于糖尿病周围神经病变为3.07 [2.23–4.22],对于糖尿病足溃疡为5.24 [2.61–10.49],以及对于新发慢性肾脏病3.49 [2.47–4.95])。纳入对时间加权平均HbA1c调整的四项敏感性分析证实了结果的可靠性。

由此可见,该研究表明较高的HbA1c变异性与全因死亡率、心血管事件和糖尿病微血管并发症的风险增加有关,并且独立于HbA1c。 

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    2020-06-12 丁鹏鹏
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  5. 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createdName=mgqwxj, createdTime=Sun Nov 17 12:12:00 CST 2019, time=2019-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383590, encodeId=78b71383590ee, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Sun Nov 17 12:12:00 CST 2019, time=2019-11-17, status=1, ipAttribution=)]
    2019-12-29 Smile2680
  6. 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  7. 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    2019-11-17 docwu2019
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    2019-11-17 mgqwxj
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由此可见,在该MI后的患者队列中,血浆LA与2型糖尿病风险呈负相关,而饮食LA与血浆LA无关。需要进一步的研究来评估血浆LA是否表示这些患者的代谢状态,而非饮食中的LA。

Nat Genet:科学家成功解析保护机体抵御2型糖尿病的关键基因功能

日前,一项刊登在国际杂志Nature Genetics上的研究报告中,来自芬兰赫尔辛基大学等机构的科学家们通过研究揭示了一种遗传突变保护机体抵御2型糖尿病的特殊生物学机制;研究者发现,制造锌转运蛋白的基因发生改变会通过增强胰腺分泌胰岛素的方式来降低个体患2型糖尿病的风险。

Diabetes Care:2型糖尿病患者睡眠与HbA1c的关系

由此可见,对于T2D患者睡眠是一个重要的可改变因素。预防失眠可能是T2D患者以睡眠为中心治疗策略的重点。