McCarthy Margaret M, Wackers Frans J Th, Davey Janice, Chyun Deborah A
New York University Rory Meyers College of Nursing, New York, NY 10010, United States.
Yale School of Medicine, New Haven, CT 06510, United States.
J Clin Transl Endocrinol. 2017 Jun 15;9:8-14. doi: 10.1016/j.jcte.2017.05.005. eCollection 2017 Sep.
Diabetes affects 29 million adults, and the majority have type 2 diabetes (T2D). Coronary artery disease (CAD) is the leading cause of death, and physical inactivity is an important risk factor. The aims of this study were to examine the contribution of physical inactivity to CAD events, and to identify the independent predictors of CAD events in a sample of older adults with T2D.
A secondary data analysis of the prospective randomized screening trial "Detection of Ischemia in Asymptomatic Diabetics (DIAD)" study. Cox proportional hazard modeling was used to examine the outcome of CAD events.
During the five years of follow-up, the CAD event rate for all subjects (n = 1119) was 8.4% ( = 94). In unadjusted analysis, physical inactivity was significantly associated with development of a CAD event. In the final model, nine baseline variables were significant predictors (p < 0.05) of a CAD: physical inactivity, race, diabetes duration, hemoglobin A1c (HbA1c), peripheral numbness, insulin use, increasing waist-to-hip ratio, family history of premature CAD, and a higher pulse pressure. In men only, there were five predictors (p < 0.05) of a CAD event: diabetes duration, peripheral numbness, HbA1c, increasing waist-to-hip ratio, and higher pulse pressure. The final model in women included three independent predictors (p < 0.05) of a CAD event: diabetes duration, a family history of premature CAD, and higher pulse pressure.
Several variables predicted CAD events in this sample of older adults with T2D. Understanding baseline characteristics that heighten risk may assist providers in intervening early to prevent its occurrence.
糖尿病影响着2900万成年人，其中大多数为2型糖尿病（T2D）患者。冠状动脉疾病（CAD）是主要死因，而身体活动不足是一个重要的危险因素。本研究的目的是探讨身体活动不足对CAD事件的影响，并确定T2D老年患者样本中CAD事件的独立预测因素。
对前瞻性随机筛查试验“无症状糖尿病患者缺血检测（DIAD）”研究进行二次数据分析。采用Cox比例风险模型来检验CAD事件的结果。
在五年的随访期间，所有受试者（n = 1119）的CAD事件发生率为8.4%（n = 94）。在未调整分析中，身体活动不足与CAD事件的发生显著相关。在最终模型中，九个基线变量是CAD的显著预测因素（p < 0.05）：身体活动不足、种族、糖尿病病程、糖化血红蛋白（HbA1c）、周围麻木、胰岛素使用、腰臀比增加、CAD家族早发史以及较高的脉压。仅在男性中，有五个CAD事件的预测因素（p < 0.05）：糖尿病病程、周围麻木、HbA1c、腰臀比增加以及较高的脉压。女性的最终模型包括三个CAD事件的独立预测因素（p < 0.05）：糖尿病病程、CAD家族早发史以及较高的脉压。
在这个T2D老年患者样本中，有几个变量可预测CAD事件。了解增加风险的基线特征可能有助于医疗人员早期干预以预防其发生。
