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2型糖尿病患者的心血管疾病患病率——基于德国大型法定医疗保险数据库的分析

Cardiovascular disease prevalence in type 2 diabetes - an analysis of a large German statutory health insurance database.

作者信息

Gabler Maximilian, Geier Silke, Mayerhoff Lukas, Rathmann Wolfgang

机构信息

Boehringer Ingelheim, Ingelheim am Rhein, Germany.

Former employee of Elsevier Health Analytics, Berlin, Germany.

出版信息

BMC Public Health. 2021 Feb 9;21(1):328. doi: 10.1186/s12889-021-10381-z.

Abstract

BACKGROUND

The aim of this study was to determine the prevalence of cardiovascular disease in persons with type 2 diabetes mellitus (T2D) in Germany.

METHODS

A claims database with an age- and sex-stratified sample of nearly 4 million individuals insured within the German statutory health system was used. All patients aged ≥18 years with T2D documented between 1 January 2015 and 31 December 2015 and complete retrospective documentation of ≥5 years (continuous enrollment in the German statutory health system) before 2015 were selected based on a validated algorithm. Cardiovascular disease (CVD) events were identified based on ICD-10 and OPS codes according to a previous clinical study (EMPA-REG OUTCOME trial).

RESULTS

The prevalence of T2D in Germany in 2015 was 9.9% (n = 324,708). Using a narrow definition of CVD, the 6-year observation period prevalence of CVD was estimated as 46.7% [95% CI: 46.52%;46.86%]. Applying a wider CVD definition, the proportion of T2D patients who showed a history of CVD was 57.1% [95% CI: 56.9%;57.24%]. The prevalence of CVD in patients with T2D ranged from 36.3 to 57.1%, depending on the observation period and definition of CVD.

CONCLUSIONS

The results underline the need for a population-based registration of cardiovascular complications in T2D.

摘要

背景

本研究旨在确定德国2型糖尿病(T2D)患者中心血管疾病的患病率。

方法

使用了一个索赔数据库,该数据库包含德国法定医疗系统中近400万按年龄和性别分层的参保个体样本。根据经过验证的算法,选取了所有在2015年1月1日至2015年12月31日期间有T2D记录且在2015年之前有≥5年(在德国法定医疗系统中持续参保)完整回顾性记录的≥18岁患者。根据先前的一项临床研究(EMPA-REG OUTCOME试验),依据ICD-10和OPS编码识别心血管疾病(CVD)事件。

结果

2015年德国T2D的患病率为9.9%(n = 324,708)。采用对CVD的狭义定义,CVD的6年观察期患病率估计为46.7% [95%置信区间:46.52%;46.86%]。采用更宽泛的CVD定义,有CVD病史的T2D患者比例为57.1% [95%置信区间:56.9%;57.24%]。T2D患者中CVD的患病率在36.3%至57.1%之间,具体取决于观察期和CVD的定义。

结论

结果强调了对T2D患者心血管并发症进行基于人群登记的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17c3/7874491/90d4380151d3/12889_2021_10381_Fig1_HTML.jpg

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