Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Emergency Medicine and Difficult Diseases Institute,Second Xiangya Hospital, Central South University, Changsha, 410011, China.
Cardiovasc Diabetol. 2020 Mar 25;19(1):39. doi: 10.1186/s12933-020-01007-6.
Although studies have shown that waist circumference (WC) is positively associated with an increased risk of cardiovascular diseases among the normal population, few studies have investigated WC in patients with type-2 diabetes mellitus (T2DM).
This was a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. The Cox proportional hazards models was used to investigate the relationship between WC and major adverse cardiovascular events (MACEs) in T2DM patients with cardiovascular disease (CVD) or high risk factors of CVD.
A total of 10,251 T2DM patients (6299 men [61.4%], 3952 women [38.6%]) were included in our analysis. The mean age was 64.0 ± 7.53 years. After a mean follow-up at 9.2 ± 2.4 years later, 1804 patients (event rate of 23 per 1000 person-years) had developed MACEs. MACEs rates in men and women were 18.0 and 26.0 events per 1000 person-years, respectively. After multivariable adjustment, each increase in WC of 1 SD increased the risk of MACEs (HR: 1.10, 95% CI 1.04-1.17; P < 0.01) in men, with a non-significant increase in MACEs (HR: 1.04, 95% CI 0.95-1.13; P = 0.40) in women. Compared with those in the first quartile of WC, male patients in the fourth quartile of WC had a hazard ratio (HR) of 1.24 (95% CI 1.05-1.46) for MACEs; female patients in the fourth quartile of WC had an HR of 1.22 (95% CI 0.96-1.56) for MACEs.
Higher WC is associated with increased risks of MACEs in male but not female T2DM patients. Trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620).
尽管研究表明腰围（WC）与普通人群心血管疾病风险的增加呈正相关，但很少有研究调查 2 型糖尿病（T2DM）患者的 WC。
这是对心血管疾病（CVD）或 CVD 高危因素的 T2DM 患者的“行动控制心血管风险糖尿病（ACCORD）研究”的事后分析。Cox 比例风险模型用于研究 WC 与主要不良心血管事件（MACEs）之间的关系。
共纳入 10251 例 T2DM 患者（6299 例男性[61.4%]，3952 例女性[38.6%]）。平均年龄为 64.0±7.53 岁。平均随访 9.2±2.4 年后，1804 例患者（事件率为每 1000 人年 23 例）发生 MACEs。男性和女性的 MACEs 发生率分别为每 1000 人年 18.0 和 26.0 例。多变量调整后，WC 每增加 1 SD，男性发生 MACEs 的风险增加（HR：1.10，95%CI 1.04-1.17；P<0.01），女性 MACEs 发生率无显著增加（HR：1.04，95%CI 0.95-1.13；P=0.40）。与 WC 第一四分位的患者相比，WC 第四四分位的男性患者发生 MACEs 的风险比（HR）为 1.24（95%CI 1.05-1.46）；WC 第四四分位的女性患者发生 MACEs 的 HR 为 1.22（95%CI 0.96-1.56）。
较高的 WC 与男性而非女性 T2DM 患者的 MACEs 风险增加相关。试验注册网址：http://www.clinicaltrials.gov。唯一标识符：NCT00000620）。
