JCEM:糖尿病成年患者体重变化后心血管疾病和死亡风险

2019-10-08 xing.T MedSci原创

由此可见,在没有实质性生活方式改变的情况下,体重减轻可能是健康状况不佳的警告信号,需要对2型糖尿病患者进行进一步检查。

强烈建议超重和肥胖的2型糖尿病成年人减肥。意外的体重减轻与全因死亡风险增加相关,但很少有研究评估其与糖尿病患者心血管疾病结局之间的关系。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究旨在评估已确诊的2型糖尿病患者2年体重变化以及随后发生心血管事件和死亡的风险。

ADVANCE是一项国际性、多中心2x2强化血糖控制和血压控制的析因试验。研究人员评估了2年体重变化的5种类型:体重减轻>10%、体重减轻4-10%、稳定(±<4%)、体重增加4-10%和体重增加>10%。研究人员采用Cox回归分析,研究人员调整干预组别、人口统计学指标、心血管疾病危险因素和糖尿病药物的使用情况。

在10081名有效体重测量数据的参与者中,平均年龄为66岁。通过2年的评估,体重减轻超过10%的占4.3%,体重减轻4-10%的占18.4%,体重增加10%以上的占5.3%。在接下来的三年试验中,与稳定体重相比,体重减轻>10%与主要大血管事件(HR为1.75,95%CI:1.26-2.44)、心血管疾病死亡率(HR为2.76,1.87-4.09)、全因死亡率(HR为2.79,2.10-3.79)密切相关,但与主要的微血管事件无关(HR为0.91,0.61-1.36)。没有证据显示基线BMI、年龄或糖尿病药物类型会改变疗效。

由此可见,在没有实质性生活方式改变的情况下,体重减轻可能是健康状况不佳的警告信号,需要对2型糖尿病患者进行进一步检查。 

原始出处:

Alexandra K Lee,et al.The Risks of Cardiovascular Disease and Mortality Following Weight Change in Adults with Diabetes: Results from ADVANCE.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/clinem/dgz045

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    2019-11-04 achengzhao
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    2020-08-23 smallant2015
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    2019-10-09 misszhang

    谢谢MedSci提供最新的资讯

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