Eur Heart J:肥胖和体重减轻与糖尿病前期和2型糖尿病患者死亡率和心血管结局成负相关

2020-05-22 MedSci原创 MedSci原创

DM或糖尿病前期的患者肥胖与较高的死亡率或不良CV结局无关。超重和中度肥胖(BMI为25–35 kg/m2)患者的死亡风险最低。与没有体重减轻相比,体重减轻是死亡率增加的独立危险因素。

糖尿病(DM)患者的体重和体重变化与死亡率和心血管(CV)结局之间的关联尚不清楚。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员旨在评估已知的心血管危险因素和2型DM或糖尿病前期患者体重、体重变化和患者结局之间的关系。

来自ORIGIN试验的12521名参与者根据BMI类别被分为:低体重[体重指数(BMI)<22kg/m2]、正常(22–24.9)、超重(25–29.9)、1–3级肥胖(分别为30–34.9、35–39.9,≥40kg/m2)。结局变量包括总的和CV死亡率以及CV死亡、非致命性卒中或心肌梗死加血运重建或心力衰竭住院的综合结局。

随访时间为6.2年(四分位数范围为5.8-6.7年)。经过多变量调整后,超重和轻度肥胖患者的总死亡率[与BMI正常的患者相比,超重患者风险比(HR)为0.80(95%置信区间(CI)为0.69-0.91);1级肥胖患者HR为0.82(0.71-0.95),P<0.01)和CV死亡率[超重患者HR为0.79(0.66-0.94);1级肥胖患者HR为0.79(0.65-0.95),P<0.05]最低。任何严重程度的肥胖都与更高的死亡率无关。体重低与死亡率[HR为1.28(1.02-1.61);心血管死亡率HR为1.34(1.01–1.79),P<0.05]增加有关。与没有体重减轻的患者相比,持续2年的体重减轻与较高的死亡率风险[HR为1.32(1.18–1.46),P<0.0001]和CV死亡率[HR为1.18(1.02–1.35)]有关。反过来,体重增加与任何不良结局无关。

由此可见,DM或糖尿病前期的患者肥胖与较高的死亡率或不良CV结局无关。超重和中度肥胖(BMI为25–35 kg/m2)患者的死亡风险最低。与没有体重减轻相比,体重减轻是死亡率增加的独立危险因素。

原始出处:

Wolfram Doehner.et al.Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial.Eur Heart J.2020.https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa293/5836748

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    2020-05-24 zhaojie88
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  5. 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  6. 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  7. 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    2020-05-24 slcumt
  8. 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GetPortalCommentsPageByObjectIdResponse(id=1043129, encodeId=3b2c10431297c, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Fri May 22 16:07:00 CST 2020, time=2020-05-22, status=1, ipAttribution=)]
    2020-05-24 hmwwww
  9. 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target=_blank style='color:#2F92EE;'>#负相关#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92265, encryptionId=34009226531, topicName=负相关)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c2115837741, createdName=hmwwww, createdTime=Sun May 24 04:07:00 CST 2020, time=2020-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=383056, encodeId=2b1838305603, content=学习了,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzTetibytbqFDmFITWHyBWbxU7S9MYibgPSqvu0sYteH0N6zXqbU0Kf3Mbdb7yWM1Kud3zPgYBibE2SZ/0, createdBy=da7696924, createdName=qingfengqishi5, createdTime=Fri May 22 22:59:56 CST 2020, time=2020-05-22, status=1, ipAttribution=), 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    2020-05-22 qingfengqishi5

    学习了,学习了

    0

  10. 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    2020-05-22 misszhang

    谢谢MedSci提供最新的资讯

    0

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