动脉粥样硬化性血脂异常与糖尿病或糖尿病前期及稳定型冠状动脉疾病患者的心血管事件：一项前瞻性队列研究。
Atherogenic dyslipidaemia and cardiovascular events in patients with diabetes or pre-diabetes and stable coronary artery disease: a prospective, cohort study.
机构信息
State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167,100037, Beijing, China.
Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 100045, Beijing, China.
出版信息
BMJ Open. 2021 Jan 17;11(1):e037340. doi: 10.1136/bmjopen-2020-037340.
OBJECTIVE
The aim of the study was to investigate the impacts of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) dyslipidaemia on prognosis in coronary artery disease (CAD) patients with different glucose metabolism status.
DESIGN
An observational cohort study.
SETTING/PARTICIPANTS: A total of 3057 patients with stable CAD were consecutively enrolled and divided into three groups according to different glucose metabolism status. Atherogenic dyslipidaemia (AD) was defined as TG ≥1.7 mmol/L and HDL-C <1.0 mmol/L for men or <1.3 mmol/L for women. The patients were further classified into six subgroups by status of AD. All subjects were followed up for the cardiovascular events (CVEs).
PRIMARY OUTCOME MEASURES
The primary endpoints were cardiovascular mortality, non-fatal myocardial infarction and non-fatal stroke.
RESULTS
During a median follow-up of 6.1 years, 308 (10.1%) CVEs occurred. No significant difference in the occurrence of CVEs was observed between normal glucose regulation (NGR) and pre-diabetes (pre-DM) groups (HR: 1.25, 95% CI 0.89 to 1.76) while DM group presented 1.45-fold higher risk of CVEs (HR: 1.45, 95% CI 1.02 to 2.05). When the participants were categorised according to combined status of two parameters, the cardiovascular risk was significantly elevated in pre-DM or DM plus AD group compared with the NGR plus non-AD group (HR: 1.76, 95% CI 1.10 to 2.80 and HR: 1.87, 95% CI 1.17 to 2.98).
CONCLUSIONS
The present study suggested that the presence of AD might affect the prognosis in patients with DM or pre-DM and stable CAD.
目的
本研究旨在探讨三酰甘油（TG）和高密度脂蛋白胆固醇（HDL-C）血脂异常对不同糖代谢状态的冠心病（CAD）患者预后的影响。
设计
观察性队列研究。
设置/参与者：连续纳入 3057 例稳定型 CAD 患者，根据不同的糖代谢状态分为三组。致动脉粥样硬化血脂异常（AD）定义为男性 TG≥1.7mmol/L 和 HDL-C<1.0mmol/L，女性 TG≥1.7mmol/L 和 HDL-C<1.3mmol/L。根据 AD 状态，将患者进一步分为六个亚组。所有患者均进行心血管事件（CVE）随访。
主要观察指标
主要终点为心血管死亡率、非致死性心肌梗死和非致死性卒中。
结果
在中位随访 6.1 年期间，发生 308 例（10.1%）CVE。正常血糖调节（NGR）和糖尿病前期（pre-DM）组之间 CVE 的发生无显著差异（HR：1.25，95%CI 0.89 至 1.76），而 DM 组 CVE 的风险增加 1.45 倍（HR：1.45，95%CI 1.02 至 2.05）。当根据两个参数的联合状态对参与者进行分类时，与 NGR 加非 AD 组相比，pre-DM 或 DM 加 AD 组的心血管风险显著升高（HR：1.76，95%CI 1.10 至 2.80 和 HR：1.87，95%CI 1.17 至 2.98）。
结论
本研究表明，AD 的存在可能会影响 DM 或 pre-DM 合并稳定型 CAD 患者的预后。
Zotero 插件