Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, PO Box 85500, 3508 AB, Utrecht, The Netherlands.
Laboratory for Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Cardiovasc Diabetol. 2018 Apr 18;17(1):58. doi: 10.1186/s12933-018-0690-3.
Type 2 diabetes mellitus (T2D) is associated with the development of left ventricular systolic dysfunction (LVSD) and heart failure with reduced ejection fraction (HFrEF). T2D patients with LVSD are at higher risk of mortality and morbidity than patients without LVSD, while progression of LVSD can be delayed or halted by the use of proven therapies. As estimates of the prevalence are scarce and vary considerably, the aim of this study was to retrieve summary estimates of the prevalence of LVSD/HFrEF in T2D and to see if there were any sex differences.
A systematic search of Medline and Embase was performed to extract the prevalence of LVSD/HFrEF in T2D (17 studies, mean age 50.1 ± 6.3 to 71.5 ± 7.5), which were pooled using random-effects meta-analysis.
The pooled prevalence of LVSD was higher in hospital populations (13 studies, n = 5835, 18% [95% CI 17-19%]), than in the general population (4 studies, n = 1707, 2% [95% CI 2-3%]). Seven studies in total reported sex-stratified prevalence estimates (men: 7% [95% CI 5-8%] vs. women: 1.3% [95% CI 0.0.2.2%]). The prevalence of HFrEF was available in one general population study (5.8% [95% CI 3.7.6%], men: 6.8% vs. women: 3.0%).
The summary prevalence of LVSD is higher among T2D patients from a hospital setting compared with from the general population, with a higher prevalence in men than in women in both settings. The prevalence of HFrEF among T2D in the population was only assessed in a single study and again was higher among men than women.
2 型糖尿病（T2D）与左心室收缩功能障碍（LVSD）和射血分数降低的心力衰竭（HFrEF）的发展有关。与没有 LVSD 的患者相比，患有 LVSD 的 T2D 患者的死亡率和发病率更高，而使用经过验证的疗法可以延迟或阻止 LVSD 的进展。由于患病率的估计值很少且差异很大，因此本研究的目的是检索 T2D 患者中 LVSD/HFrEF 的患病率汇总估计值，并观察是否存在性别差异。
系统检索 Medline 和 Embase 以提取 T2D 中 LVSD/HFrEF 的患病率（17 项研究，平均年龄 50.1±6.3 至 71.5±7.5），并使用随机效应荟萃分析进行汇总。
在医院人群中（13 项研究，n=5835，18%[95%CI 17-19%]），LVSD 的总体患病率高于一般人群（4 项研究，n=1707，2%[95%CI 2-3%]）。共有 7 项研究报告了性别分层患病率估计值（男性：7%[95%CI 5-8%] vs. 女性：1.3%[95%CI 0.0.2.2%]）。一项一般人群研究报告了 HFrEF 的患病率（5.8%[95%CI 3.7.6%]，男性：6.8%vs. 女性：3.0%）。
与一般人群相比，来自医院环境的 T2D 患者的 LVSD 总体患病率较高，且在两种环境下，男性的患病率均高于女性。只有一项研究评估了 T2D 人群中 HFrEF 的患病率，且男性的患病率也高于女性。
