Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Diabetes Metab Res Rev. 2016 Sep;32(6):596-606. doi: 10.1002/dmrr.2776. Epub 2016 Mar 8.
To identify risk factors for cardiovascular disease (CVD) and mortality events in patients with type 2 diabetes and to calculate their population attributable fraction among a representative Iranian population.
A total of 1198 patients with type 2 diabetes (504 men and 694 women), aged ≥30 years, without prevalent CVD, with a median follow-up of 10 years were included in current study. To examine the association between risk factors and their outcomes, multivariate sex-adjusted Cox proportional hazard regression models were used.
During the study, 281 and 172 participants experienced CVD and all-cause mortality events, respectively. Regarding CVD events, fasting plasma glucose (FPG) level of 7.22-<10 mmol/L [hazard ratio (HR): 1.46, 95% CI 1.12-1.96], FPG level ≥10 mmol/L (HR 2.04, 1.53-2.72), hypertension (HR 1.65, 1.28-2.13), hypercholesterolaemia (HR 1.96, 1.40-2.75) and high waist to hip ratio (HR 1.30, 0.99-1.70; p = 0.051) were significant predictors, and corresponding population attributable fractions were 9.76, 17.84, 23.26, 41.63 and 14.76%, respectively. Considering all-cause mortality events, hypertension (HR 1.70, 1.23-2.36), FPG level ≥10 mmol/L (HR 2.31, 1.55-3.20) and smoking (HR 1.45, 1.03-2.04) were significant predictors, and corresponding population attributable fractions were 25.81, 20.88 and 11.18%, respectively. Meanwhile, being overweight or obese was associated with lower all-cause and CVD mortality events.
Among modifiable risk factors in patients with type 2 diabetes, hypercholesterolaemia and central adiposity for CVD, smoking for mortality events and hypertension and poor glycaemic control for both outcomes need to be paid most attention by healthcare professionals. Copyright © 2016 John Wiley & Sons, Ltd.
本研究旨在确定 2 型糖尿病患者发生心血管疾病（CVD）和死亡事件的风险因素，并计算其在伊朗代表性人群中的人群归因分数。
本研究共纳入 1198 例年龄≥30 岁、无 CVD 病史的 2 型糖尿病患者（504 例男性和 694 例女性），中位随访时间为 10 年。采用多变量性别校正 Cox 比例风险回归模型来检验各风险因素与结局之间的相关性。
在研究期间，281 例和 172 例患者分别发生 CVD 事件和全因死亡事件。在 CVD 事件方面，空腹血糖（FPG）水平为 7.22-<10mmol/L（危险比[HR]：1.46，95%置信区间[CI] 1.12-1.96）、FPG 水平≥10mmol/L（HR 2.04，1.53-2.72）、高血压（HR 1.65，1.28-2.13）、高胆固醇血症（HR 1.96，1.40-2.75）和高腰臀比（HR 1.30，0.99-1.70；p=0.051）是显著的预测因素，相应的人群归因分数分别为 9.76%、17.84%、23.26%、41.63%和 14.76%。在全因死亡事件方面，高血压（HR 1.70，1.23-2.36）、FPG 水平≥10mmol/L（HR 2.31，1.55-3.20）和吸烟（HR 1.45，1.03-2.04）是显著的预测因素，相应的人群归因分数分别为 25.81%、20.88%和 11.18%。同时，超重或肥胖与全因和 CVD 死亡率降低有关。
在 2 型糖尿病患者的可改变风险因素中，高胆固醇血症和中心性肥胖与 CVD 相关，吸烟与死亡率相关，高血压和血糖控制不佳与这两种结局均相关，这些都需要医护人员给予更多关注。版权所有©2016 约翰威立父子公司。
