Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California; Department of Population Health Sciences, University of California, Irvine, California.
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California; Department of Population Health Sciences, University of California, Irvine, California.
Am J Cardiol. 2019 Aug 15;124(4):522-527. doi: 10.1016/j.amjcard.2019.05.035. Epub 2019 May 28.
Cardiovascular disease (CVD) remains leading cause of death among adults with type 2 diabetes (T2DM). There is a lack of recent national data on attainment of single and multiple CVD risk factor targets among adults with T2DM with and without CVD. We identified 1179 T2DM adults (projected to 19.7 million in the US population) aged ≥18 years from the US National Health and Nutrition Examination Survey (NHANES) 2013-2016 and examined those at target for hemoglobin A1c (HbA1c <7.0%, <8.0% if CVD), blood pressure (BP <130/80 mm Hg), low-density lipoprotein cholesterol (LDL-C <100 mg/dL non-CVD and LDL-C <70 mg/dL CVD), nonsmoking status, and body mass index (BMI <30 kg/mand BMI <25 kg/m) individually and as a composite in those with versus without prior CVD. Overall, around half of T2DM adults were at target control of HbA1c (55.8%), BP (51.3%), LDL-C (49.3%), with more being nonsmokers (84.3%). The proportion at target for these factors was slightly higher among those with CVD except for LDL-C. BMI was least frequently at target control (9.1% for BMI <25 kg/m) compared to other risk factors. Moreover, only 17.3% of T2DM patients reached composite target control of HbA1c, BP and LDL-C, with 16.0% reaching target control when nonsmoking status was included and <10% if we included BMI targets. The proportion of patients at composite control was lower in those with versus without with prior CVD. Less than one-fifth adults with T2DM are at composite CVD risk factor control for HbA1c, BP, LDL-C, and nonsmoking status.
心血管疾病 (CVD) 仍然是 2 型糖尿病 (T2DM) 患者的主要死亡原因。目前缺乏关于 T2DM 患者（无论是否患有 CVD）在单一和多种 CVD 风险因素目标方面的最新全国性数据。我们从美国国家健康和营养调查 (NHANES) 2013-2016 年的数据中确定了 1179 名年龄≥18 岁的 T2DM 成年人（预计在美国人口中为 1970 万），并检查了那些达到血红蛋白 A1c（HbA1c<7.0%，CVD 时<8.0%）、血压（BP<130/80mmHg）、低密度脂蛋白胆固醇（LDL-C<100mg/dL 非 CVD 和 LDL-C<70mg/dL CVD）、非吸烟状态和身体质量指数（BMI<30kg/m 和 BMI<25kg/m）的目标值的患者，分别在有或无既往 CVD 的患者中作为复合因素。总体而言，约一半的 T2DM 患者的 HbA1c（55.8%）、BP（51.3%）、LDL-C（49.3%）控制达标，更多的是不吸烟（84.3%）。除 LDL-C 外，有 CVD 的患者这些因素的达标比例略高。与其他危险因素相比，BMI 达标控制的比例最低（BMI<25kg/m 的比例为 9.1%）。此外，只有 17.3%的 T2DM 患者达到 HbA1c、BP 和 LDL-C 的综合目标控制，当包括非吸烟状态时，16.0%达到目标控制，当包括 BMI 目标时，<10%。与没有 CVD 的患者相比，有 CVD 的患者达到综合控制的比例较低。不到五分之一的 T2DM 患者达到 HbA1c、BP、LDL-C 和非吸烟状态的综合 CVD 危险因素控制。
