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握力是糖尿病心血管结局的独立预测因子。

Handgrip Strength Is an Independent Predictor of Cardiovascular Outcomes in Diabetes Mellitus.

机构信息

Department of Cardiovascular Medicine, Nara City Hospital.

Department of Cardiovascular Medicine, Nara Medical University.

出版信息

Int Heart J. 2021;62(1):50-56. doi: 10.1536/ihj.20-677.

Abstract

Diabetes mellitus (DM) is associated with an increased incidence of cardiovascular events and an elevated prevalence of sarcopenia. However, the relationship between cardiovascular events and sarcopenia in patients with DM remains unclear. This study examined this relationship and investigated the predictors of cardiovascular events in this population.This study enrolled 161 patients with DM and no history of cardiovascular diseases who were admitted to our hospital for the treatment of DM between September 2012 and December 2015. Patients were divided into sarcopenia and non-sarcopenia groups, and were followed until March 2019. The primary endpoint was major adverse cardiovascular events (MACE).The mean age was 65.9 ± 1.8 years old and the mean follow-up period was 4.1 ± 0.8 years. The log-rank test indicated that MACE differed significantly between the two groups (P < 0.0001). Multivariate Cox hazard analysis identified the cardio-ankle vascular index (CAVI) and handgrip strength as independent predictors of MACE (hazard ratio [HR] = 1.18, P = 0.039; and HR = 0.70, P = 0.016, respectively).Handgrip strength is an indicator of sarcopenia in diabetic patients, and together with CAVI it was independently associated with the incidence of MACE. This suggests that the handgrip strength test might be useful in the management of patients with DM at high risk of cardiovascular outcomes.

摘要

糖尿病(DM)与心血管事件发生率增加和肌肉减少症患病率升高有关。然而,DM 患者心血管事件与肌肉减少症之间的关系尚不清楚。本研究探讨了这种关系,并调查了该人群中心血管事件的预测因素。

本研究纳入了 2012 年 9 月至 2015 年 12 月期间因 DM 住院治疗且无心血管疾病史的 161 例 DM 患者。患者分为肌肉减少症组和非肌肉减少症组,并随访至 2019 年 3 月。主要终点是主要不良心血管事件(MACE)。

患者的平均年龄为 65.9 ± 1.8 岁,平均随访时间为 4.1 ± 0.8 年。对数秩检验表明两组间 MACE 差异有统计学意义(P < 0.0001)。多因素 Cox 风险分析确定了心血管踝血管指数(CAVI)和握力是 MACE 的独立预测因素(风险比 [HR] = 1.18,P = 0.039;和 HR = 0.70,P = 0.016)。

握力是糖尿病患者肌肉减少症的一个指标,与 CAVI 一起,与 MACE 的发生独立相关。这表明握力测试可能对管理有心血管结局风险的 DM 患者有用。

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