Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Int J Cardiol. 2018 Jul 1;262:66-70. doi: 10.1016/j.ijcard.2018.03.099. Epub 2018 Mar 24.
BACKGROUND: The association between type 1 diabetes mellitus (T1DM) and specific cardiovascular diseases (CVD) is uncertain. Furthermore, data on type 2 diabetes mellitus (T2DM) in relation to risk of aortic valve stenosis, atrial fibrillation, abdominal aortic aneurysm, and intracerebral hemorrhage are scarce and inconclusive. We examined the associations of T1DM and T2DM with incidence of seven CVD outcomes. METHODS: This study comprised 71,483 Swedish adults from two population-based prospective cohorts. T1DM and T2DM diagnosis and incident CVD cases were ascertained through linkage with the population-based registers. RESULTS: T1DM was associated with myocardial infarction (hazard ratio [HR] 3.26; 95% confidence interval [CI] 2.47-4.30), heart failure (HR 2.68; 95% CI 1.76-4.09), and ischemic stroke (HR 2.61; 95% CI 1.80-3.79). Increased risk of myocardial infarction, ischemic stroke, and heart failure was also observed in T2DM patients and the magnitude of the associations increased with longer T2DM duration. T2DM was also associated with an increased risk of aortic valve stenosis (HR 1.34; 95% CI 1.05-1.71) and with lower risk of abdominal aortic aneurysm (HR 0.57; 95% CI 0.40-0.82) and intracerebral hemorrhage (HR 0.51; 95% CI 0.30-0.88). Only long-term T2DM (≥20 years) was associated with an increased risk of atrial fibrillation (HR 1.44; 95% CI 1.02-2.04). CONCLUSION: T1DM and T2DM are associated with increased risk of major CVD outcomes. TRIAL REGISTRATION: The Cohort of Swedish Men and the Swedish Mammography Cohort are registered at clinicaltrials.gov as NCT01127711 and NCT01127698, respectively.
背景:1 型糖尿病(T1DM)与特定心血管疾病(CVD)之间的关联尚不确定。此外,关于 2 型糖尿病(T2DM)与主动脉瓣狭窄、心房颤动、腹主动脉瘤和脑出血风险的关系的数据很少且尚无定论。我们研究了 T1DM 和 T2DM 与七种 CVD 结局的发病风险之间的关系。
方法:本研究纳入了来自两个基于人群的前瞻性队列的 71483 名瑞典成年人。通过与基于人群的登记处进行链接,确定 T1DM 和 T2DM 的诊断和新发 CVD 病例。
结果:T1DM 与心肌梗死(HR 3.26;95%CI 2.47-4.30)、心力衰竭(HR 2.68;95%CI 1.76-4.09)和缺血性卒中(HR 2.61;95%CI 1.80-3.79)有关。T2DM 患者也存在心肌梗死、缺血性卒中和心力衰竭风险增加的情况,且随着 T2DM 持续时间的延长,相关性的程度也随之增加。T2DM 还与主动脉瓣狭窄风险增加相关(HR 1.34;95%CI 1.05-1.71),与腹主动脉瘤(HR 0.57;95%CI 0.40-0.82)和脑出血(HR 0.51;95%CI 0.30-0.88)风险降低相关。只有长期 T2DM(≥20 年)与心房颤动风险增加相关(HR 1.44;95%CI 1.02-2.04)。
结论:T1DM 和 T2DM 与主要 CVD 结局的发病风险增加有关。
试验注册:瑞典男性队列和瑞典乳腺 X 线摄影队列分别在 clinicaltrials.gov 上注册为 NCT01127711 和 NCT01127698。
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