JCEM:糖尿病患者体重变化后心血管疾病的风险

2022-09-06 MedSci原创 MedSci原创

2型糖尿病患者18个月以上体重的增加和减少,特别是体重变化≥5%,可能是不良心血管结局的预警信号。

糖尿病已经成为一个主要的全球健康问题。大量证据表明,糖尿病是心血管疾病(CVD)的主要危险因素。因此,对糖尿病患者进行有效的健康管理对预防心血管疾病的发生至关重要。近年来,许多国家都制定了糖尿病管理指南,而体重控制是这些指南的一个重要方面。体重管理被认为是降低成人糖尿病患者心血管代谢风险因素的关键,但体重变化对糖尿病患者心血管疾病的影响尚不清楚。

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,该研究的主要目的是评估已确诊的2型糖尿病患者18个月体重变化和随后大血管和微血管并发症的风险。

该研究由队列研究和荟萃分析组成。在队列研究中,18个月体重变化分为:体重增加≥5%、体重增加1%-5%、体重稳定(-1%-1%)、体重减轻1%-5%和体重减轻≥5%。研究人员采用Cox回归分析估计风险比(HR)和95%可信区间(95%CI)。然后,研究人员使用随机效应模型将研究与其他相关研究结合起来,汇集了研究结果。

在队列研究中,纳入了8920名有效体重测量的参与者。与体重稳定的患者相比,体重改变的患者发生总血管并发症的风险更高(体重增加≥5%:HR=1.43,95%CI为1.10-1.85;体重增加1-5%:HR=1.44,95%CI为1.02-2.03;体重减轻≥5%:HR=1.58,95%CI为1.20-2.08),大血管并发症(体重增加≥5%:HR=1.84,95%CI为1.16-2.91;体重减轻1-5%:HR=1.91,95%CI为1.06-3.43;体重减轻≥5%:HR=2.18,95%CI为1.36-3.49)和微血管并发症(体重减轻≥5%:HR=1.48,95%CI为1.06-2.06)。meta分析也得到了类似的结果。

由此可见,2型糖尿病患者18个月以上体重的增加和减少,特别是体重变化≥5%,可能是不良心血管结局的预警信号。

原始出处:

Yue Dong,et al.The Risks of Cardiovascular Disease Following Weight Change in Adults with Diabetes: A Cohort Study and Meta-analysis.JCEM.2022.https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgac485/6666536?redirectedFrom=fulltext.

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    2023-06-15 achengzhao
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    2023-04-04 smallant2015
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    2022-09-06 wwyu2016

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