靶器官病变作为糖尿病患者死亡率预测指标的相关性

Relevance of target-organ lesions as predictors of mortality in patients with diabetes mellitus.

作者信息

Bianco Henrique Tria, Izar Maria Cristina, Fonseca Henrique Andrade, Póvoa Rui Manuel, Saraiva José Francisco, Forti Adriana, Jardim Paulo Cesar B V, Introcaso Luis, Yugar-Toledo Juan, Xavier Hermes Tóros, Faludi André Arpad, Fonseca Francisco A H

机构信息

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil.

出版信息

Arq Bras Cardiol. 2014 Oct;103(4):272-81. doi: 10.5935/abc.20140112. Epub 2014 Aug 1.

DOI:10.5935/abc.20140112

PMID:25098376

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4206357/

Abstract

BACKGROUND

Patients with diabetes are in extract higher risk for fatal cardiovascular events.

OBJECTIVE

To evaluate major predictors of mortality in subjects with type 2 diabetes.

METHODS

A cohort of 323 individuals with type 2 diabetes from several regions of Brazil was followed for a long period. Baseline electrocardiograms, clinical and laboratory data obtained were used to determine hazard ratios (HR) and confidence interval (CI) related to cardiovascular and total mortality.

RESULTS

After 9.2 years of follow-up (median), 33 subjects died (17 from cardiovascular causes). Cardiovascular mortality was associated with male gender; smoking; prior myocardial infarction; long QTc interval; left ventricular hypertrophy; and eGFR <60 mL/min. These factors, in addition to obesity, were predictors of total mortality. Cardiovascular mortality was adjusted for age and gender, but remained associated with: smoking (HR = 3.8; 95% CI 1.3-11.8; p = 0.019); prior myocardial infarction (HR = 8.5; 95% CI 1.8-39.9; p = 0.007); eGFR < 60 mL/min (HR = 9.5; 95% CI 2.7-33.7; p = 0.001); long QTc interval (HR = 5.1; 95% CI 1.7-15.2; p = 0.004); and left ventricular hypertrophy (HR = 3.5; 95% CI 1.3-9.7; p = 0.002). Total mortality was associated with obesity (HR = 2.3; 95% CI 1.1-5.1; p = 0.030); smoking (HR = 2.5; 95% CI 1.0-6.1; p = 0.046); prior myocardial infarction (HR = 3.1; 95% CI 1.4-6.1; p = 0.005), and long QTc interval (HR = 3.1; 95% CI 1.4-6.1; p = 0.017).

CONCLUSIONS

Biomarkers of simple measurement, particularly those related to target-organ lesions, were predictors of mortality in subjects with type 2 diabetes.

摘要

背景

糖尿病患者发生致命心血管事件的风险更高。

目的

评估2型糖尿病患者死亡的主要预测因素。

方法

对来自巴西多个地区的323名2型糖尿病患者进行了长期随访。利用获得的基线心电图、临床和实验室数据来确定与心血管死亡率和总死亡率相关的风险比（HR）和置信区间（CI）。

结果

经过9.2年（中位数）的随访，33名受试者死亡（17例死于心血管原因）。心血管死亡率与男性性别、吸烟、既往心肌梗死、QTc间期延长、左心室肥厚以及估算肾小球滤过率（eGFR）<60 mL/min有关。除肥胖外，这些因素也是总死亡率的预测因素。对心血管死亡率进行年龄和性别校正后，其仍与以下因素相关：吸烟（HR = 3.8；95%CI 1.3 - 11.8；p = 0.019）；既往心肌梗死（HR = 8.5；95%CI 1.8 - 39.9；p = 0.007）；eGFR < 60 mL/min（HR = 9.5；95%CI 2.7 - 33.7；p = 0.001）；QTc间期延长（HR = 5.1；95%CI 1.7 - 15.2；p = 0.004）；以及左心室肥厚（HR = 3.5；95%CI 1.3 - 9.7；p = 0.002）。总死亡率与肥胖（HR = 2.3；95%CI 1.1 - 5.1；p = 0.030）、吸烟（HR = 2.5；95%CI 1.0 - 6.1；p = 0.046）、既往心肌梗死（HR = 3.1；95%CI 1.4 - 6.1；p = 0.005）以及QTc间期延长（HR = 3.1；95%CI 1.4 - 6.1；p = 0.017）有关。