School of Medicine, The University of Notre Dame, Australia.
Medical School, The University of Western Australia, Fremantle Hospital, Fremantle, Western Australia, Australia.
J Diabetes Complications. 2021 Feb;35(2):107773. doi: 10.1016/j.jdiacomp.2020.107773. Epub 2020 Oct 27.
To determine the relative incidence and predictors of pulmonary arterial hypertension (PAH) in type 2 diabetes.
Hospitalizations for/with and death from/with PAH, and all-cause mortality, were ascertained from validated databases for participants from the longitudinal, community-based Fremantle Diabetes Study Phase I (FDS1; n = 1287) and age-, sex- and zip code-matched people without diabetes (n = 5153) between entry (1993-1996) and end-2017. Incidence rates (IRs) and IR ratios (IRRs) were calculated. Cox proportional hazards and competing risk models generated cause-specific (cs) and subdistribution (sd) hazard ratios (HRs) for incident PAH.
In the pooled cohort (mean age 64.0 years, 49% males), 49 (3.8%) of the type 2 diabetes participants and 133 (2.6%) of those without diabetes developed PAH during 106,556 person-years of follow-up (IRs (95% CI) 262 (194-346) and 151 (127-179) /100,000 person-years, respectively; IRR 1.73 (1.22-2.42), P = 0.001). Type 2 diabetes was associated with an unadjusted csHR of 1.97 (1.42-2.74) and sdHR of 1.44 (1.04-2.00) (P ≤ 0.03); after adjustment for age, sex, and co-morbidities, these were 1.43 (0.83-2.47) and 1.36 (0.97-1.91), respectively (P ≥ 0.07).
Type 2 diabetes is associated with an increased risk of PAH but this is no longer significant after adjustment for other explanatory variables and the competing risk of death.
确定 2 型糖尿病患者肺动脉高压（PAH）的相对发病率和预测因素。
从验证过的数据库中确定 2 型糖尿病患者和无糖尿病患者的 PAH 住院治疗/并发、PAH 死亡/并发以及全因死亡率，这些患者来自于纵向、基于社区的弗里曼特尔糖尿病研究第一阶段（FDS1；n=1287）和年龄、性别及邮政编码匹配的无糖尿病患者（n=5153），他们在 1993-1996 年入组至 2017 年底期间接受了随访。计算发病率（IRs）和发病率比（IRRs）。Cox 比例风险和竞争风险模型为 PAH 发病生成了特定原因（cs）和亚分布（sd）风险比（HRs）。
在合并队列中（平均年龄 64.0 岁，49%为男性），2 型糖尿病患者中有 49 例（3.8%）和无糖尿病患者中有 133 例（2.6%）在 106556 人年的随访期间发生了 PAH（IRs（95%CI）分别为 262（194-346）和 151（127-179）/100000 人年；IRR 1.73（1.22-2.42），P=0.001）。2 型糖尿病与未经调整的 csHR 1.97（1.42-2.74）和 sdHR 1.44（1.04-2.00）相关（P≤0.03）；在调整年龄、性别和合并症后，这些 HR 分别为 1.43（0.83-2.47）和 1.36（0.97-1.91）（P≥0.07）。
2 型糖尿病与 PAH 风险增加相关，但在调整其他解释变量和死亡的竞争风险后，这种相关性不再显著。
