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低密度脂蛋白胆固醇目标达标率及韩国糖尿病患者达标情况的医师认知

Low Density Lipoprotein Cholesterol Target Goal Attainment Rate and Physician Perceptions about Target Goal Achievement in Korean Patients with Diabetes.

机构信息

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Diabetes Metab J. 2011 Dec;35(6):628-36. doi: 10.4093/dmj.2011.35.6.628. Epub 2011 Dec 26.

Abstract

BACKGROUND

This study aims to investigate the discrepancy between clinicians' perceptions and actual achievement rates of low density lipoprotein cholesterol (LDL-C) in Korean patients with diabetes according to updated American Diabetes Association (ADA)/American College of Cardiology Foundation (ACC) recommendations.

METHODS

This is a multi-center, retrospective, non-interventional, observational study. Diabetic patients aged 18 years or older were eligible if they had been diagnosed with hypercholesterolemia or were receiving a lipid-lowering therapy between May 2010 and August 2010. The information was obtained by reviewing medical records and using a self-completed questionnaire to examine physician perceptions.

RESULTS

A total of 2,591 subjects who satisfied the inclusion criteria were enrolled. Highest-risk and high-risk patients accounted for 61.9% and 38.1% of the patients, respectively. Although most (96.3%) underwent a statin monotherapy or a statin-based combination therapy, just 47.4% of patients attained the LDL-C target. However, the physicians' perceptions on target achievement rate (70.6%) were different from the actual results (47.4%). Many patients (65.3%) remained on the starting doses of statins, despite evidence of poor achievement of lipid goals.

CONCLUSION

Only less than half of patients with diabetes attained the LDL-C goal. The surveys showed that poor physician performance might be due to the lack of recognition on ADA/ACC consensus causing a low LDL-C target attainment rate. Therefore, changes in doctor perception are needed to attain target LDL-C level and reduce cardiovascular risk in Korean patients with diabetes.

摘要

背景

本研究旨在根据美国糖尿病协会(ADA)/美国心脏病学会基金会(ACC)的最新建议,调查韩国糖尿病患者的临床医生对低密度脂蛋白胆固醇(LDL-C)的认知与实际达标率之间的差异。

方法

这是一项多中心、回顾性、非干预性、观察性研究。年龄在 18 岁或以上的糖尿病患者,如果在 2010 年 5 月至 2010 年 8 月期间被诊断为高胆固醇血症或正在接受降脂治疗,则符合入选条件。通过查阅病历和使用自我完成的问卷来检查医生的认知,获取信息。

结果

共有 2591 名符合纳入标准的患者入选。高危和高风险患者分别占患者的 61.9%和 38.1%。尽管大多数(96.3%)接受了他汀类药物单一疗法或他汀类药物联合治疗,但只有 47.4%的患者达到了 LDL-C 目标。然而,医生对目标达标率(70.6%)的认知与实际结果(47.4%)不同。尽管血脂目标达标情况较差,但许多患者(65.3%)仍在使用他汀类药物的起始剂量。

结论

只有不到一半的糖尿病患者达到了 LDL-C 目标。调查显示,医生表现不佳可能是由于缺乏对 ADA/ACC 共识的认识,导致 LDL-C 目标达标率较低。因此,需要改变医生的认知,以达到目标 LDL-C 水平并降低韩国糖尿病患者的心血管风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e968/3253974/9e1da277b486/dmj-35-628-g001.jpg

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