Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea.
Diabetes Metab J. 2011 Dec;35(6):619-27. doi: 10.4093/dmj.2011.35.6.619. Epub 2011 Dec 26.
Patients with type 2 diabetes have an increased risk of cardiovascular disease. Few studies have evaluated the cardiovascular disease (CVD) risk simultaneously using the United Kingdom Prospective Diabetes Study (UKPDS) risk engine and non-invasive vascular tests in patients with newly diagnosed type 2 diabetes.
Participants (n=380; aged 20 to 81 years) with newly diagnosed type 2 diabetes were free of clinical evidence of CVD. The 10-year coronary heart disease (CHD) and stroke risks were calculated for each patient using the UKPDS risk engine. Carotid intima media thickness (CIMT), flow mediated dilation (FMD), pulse wave velocity (PWV) and augmentation index (AI) were measured. The correlations between the UKPDS risk engine and the non-invasive vascular tests were assessed using partial correlation analysis, after adjusting for age, and multiple regression analysis.
The mean 10-year CHD and 10-year stroke risks were 14.92±11.53% and 4.03±3.95%, respectively. The 10-year CHD risk correlated with CIMT (P<0.001), FMD (P=0.017), and PWV (P=0.35) after adjusting for age. The 10-year stroke risk correlated only with the mean CIMT (P<0.001) after adjusting for age. FMD correlated with age (P<0.01) and systolic blood pressure (P=0.09). CIMT correlated with age (P<0.01), HbA1c (P=0.05), and gender (P<0.01).
The CVD risk is increased at the onset of type 2 diabetes. CIMT, FMD, and PWV along with the UKPDS risk engine should be considered to evaluate cardiovascular disease risk in patients with newly diagnosed type 2 diabetes.
2 型糖尿病患者的心血管疾病风险增加。很少有研究同时使用英国前瞻性糖尿病研究(UKPDS)风险引擎和非侵入性血管测试来评估新诊断的 2 型糖尿病患者的心血管疾病(CVD)风险。
380 名(年龄 20 至 81 岁)新诊断为 2 型糖尿病且无临床心血管疾病证据的参与者纳入本研究。每位患者均使用 UKPDS 风险引擎计算 10 年冠心病(CHD)和中风风险。测量颈动脉内膜中层厚度(CIMT)、血流介导的扩张(FMD)、脉搏波速度(PWV)和增强指数(AI)。使用偏相关分析评估 UKPDS 风险引擎与非侵入性血管测试之间的相关性,在调整年龄后进行多元回归分析。
平均 10 年 CHD 和 10 年中风风险分别为 14.92±11.53%和 4.03±3.95%。调整年龄后,10 年 CHD 风险与 CIMT(P<0.001)、FMD(P=0.017)和 PWV(P=0.35)相关。调整年龄后,10 年中风风险仅与平均 CIMT 相关(P<0.001)。FMD 与年龄(P<0.01)和收缩压(P=0.09)相关。CIMT 与年龄(P<0.01)、HbA1c(P=0.05)和性别(P<0.01)相关。
2 型糖尿病发病时心血管疾病风险增加。应考虑 CIMT、FMD、PWV 以及 UKPDS 风险引擎,以评估新诊断的 2 型糖尿病患者的心血管疾病风险。