霍伦糖尿病护理系统（DCS）队列。这是一个在荷兰接受初级护理的2型糖尿病患者的前瞻性队列。
The Hoorn Diabetes Care System (DCS) cohort. A prospective cohort of persons with type 2 diabetes treated in primary care in the Netherlands.
作者信息
van der Heijden Amber Awa, Rauh Simone P, Dekker Jacqueline M, Beulens Joline W, Elders Petra, 't Hart Leen M, Rutters Femke, van Leeuwen Nienke, Nijpels Giel
机构信息
Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
出版信息
BMJ Open. 2017 Jun 6;7(5):e015599. doi: 10.1136/bmjopen-2016-015599.
PURPOSE
People with type 2 diabetes (T2D) have a doubled morbidity and mortality risk compared with persons with normal glucose tolerance. Despite treatment, clinical targets for cardiovascular risk factors are not achieved. The Hoorn Diabetes Care System cohort (DCS) is a prospective cohort representing a comprehensive dataset on the natural course of T2D, with repeated clinical measures and outcomes. In this paper, we describe the design of the DCS cohort.
PARTICIPANTS
The DCS consists of persons with T2D in primary care from the West-Friesland region of the Netherlands. Enrolment in the cohort started in 1998 and this prospective dynamic cohort currently holds 12 673 persons with T2D.
FINDINGS TO DATE
Clinical measures are collected annually, with a high internal validity due to the centrally organised standardised examinations. Microvascular complications are assessed by measuring kidney function, and screening feet and eyes. Information on cardiovascular disease is obtained by 1) self-report, 2) electrocardiography and 3) electronic patient records. In subgroups of the cohort, biobanking and additional measurements were performed to obtain information on, for example, lifestyle, depression and genomics. Finally, the DCS cohort is linked to national cancer and all-cause mortality registers. A selection of published findings from the DCS includes identification of subgroups with distinct development of haemoglobin A1c, blood pressure and retinopathy, and their predictors; validation of a prediction model for personalised retinopathy screening; the assessment of the role of genetics in development and treatment of T2D, providing options for personalised medicine.
FUTURE PLANS
We will continue with the inclusion of persons with newly diagnosed T2D, follow-up of persons in the cohort and linkage to morbidity and mortality registries. Currently, we are involved in (inter)national projects on, among others, biomarkers and prediction models for T2D and complications and we are interested in collaborations with external researchers.
TRIAL REGISTRATION
ISRCTN26257579.
目的
与糖耐量正常者相比，2型糖尿病（T2D）患者的发病和死亡风险增加一倍。尽管进行了治疗，但心血管危险因素的临床目标仍未实现。霍伦糖尿病护理系统队列（DCS）是一个前瞻性队列，代表了关于T2D自然病程的综合数据集，并进行了重复的临床测量和结局评估。在本文中，我们描述了DCS队列的设计。
参与者
DCS由荷兰西弗里斯兰地区初级保健中的T2D患者组成。该队列于1998年开始招募，这个前瞻性动态队列目前有12673名T2D患者。
迄今的研究结果
每年收集临床测量数据，由于采用集中组织的标准化检查，内部效度较高。通过测量肾功能、筛查足部和眼睛来评估微血管并发症。通过以下方式获取心血管疾病信息：1）自我报告，2）心电图检查，3）电子病历。在队列的亚组中，进行了生物样本库采集和额外测量，以获取有关生活方式、抑郁和基因组学等方面的信息。最后，DCS队列与国家癌症和全因死亡登记处相链接。DCS已发表的部分研究结果包括：识别糖化血红蛋白、血压和视网膜病变发展情况不同的亚组及其预测因素；验证个性化视网膜病变筛查预测模型；评估遗传学在T2D发生和治疗中的作用，为个性化医疗提供选择。
未来计划
我们将继续纳入新诊断的T2D患者，对队列中的患者进行随访，并与发病和死亡登记处相链接。目前，我们参与了（国际）关于T2D及其并发症的生物标志物和预测模型等项目，并且有兴趣与外部研究人员合作。
试验注册
ISRCTN26257579。
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