Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China.
Medical Records and Statistics Department, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Sci Rep. 2021 Mar 1;11(1):4839. doi: 10.1038/s41598-021-84015-0.
To investigate the potential benefits of acarbose therapy on cardiovascular events (CVD) in Type 2 diabetes (T2DM) in an urban community over 10-year follow-up. The study population of Beijing Community Diabetes Study (BCDS) were type 2 diabetes (T2DM) living in 21 communities in Beijing. All patients received comprehensive intervention in accordance with the Chinese guidelines for the prevention and treatment of diabetes. Professors in endocrinology from top tier hospitals regularly visited the communities for consultations, which was a feature of this study. A total of 1797 T2DM in BCDS study had complete screening data, including blood glucose, blood pressure, lipid profiles and acarbose continuous therapy. After 10-year follow-up, the risks of CVD outcomes were assessed according to whether patients had received acarbose therapy or not. All patients were followed-up to assess the long-term effects of the multifactorial interventions. At baseline, compared with the acarbose therapy free in T2DM, there was no significant difference in achieving the joint target control in patients with acarbose therapy. From the beginning of 8th year follow-up, the joint target control rate in patients with acarbose therapy was significantly higher than that of acarbose therapy free. During the 10-year follow-up, a total of 446 endpoint events occurred, including all-cause death, cardiovascular events, cerebrovascular events. The incidences of myocardial infarction (from the 4th year of follow-up) and all-cause death (from the 2nd year of follow-up) in patients who received acarbose therapy were significantly lower than that of acarbose therapy free respectively. In Cox multivariate analyses, there were significant differences in incidences of myocardial infarction and all-cause death between afore two groups during the 10-year follow-up, and the adjusted HRs were 0.50 and 0.52, respectively. After multifactorial interventions, T2DM with acarbose therapy revealed significant reductions of myocardial infarction and all-cause death. The long-term effects of with acarbose therapy on improving joint target control might be one of the main reasons of myocardial infarction and all-cause death reduction.Trial Registration: ChiCTR-TRC-13003978, ChiCTR-OOC-15006090.
在一项为期 10 年的随访中，研究阿卡波糖治疗对城市社区 2 型糖尿病（T2DM）患者心血管事件（CVD）的潜在益处。北京社区糖尿病研究（BCDS）的研究人群为居住在北京 21 个社区的 2 型糖尿病（T2DM）患者。所有患者均按照中国糖尿病防治指南接受了综合干预。内分泌学教授定期到社区进行咨询，这是本研究的一个特点。BCDS 研究中共有 1797 例 T2DM 患者有完整的筛查数据，包括血糖、血压、血脂谱和阿卡波糖连续治疗。经过 10 年的随访，根据患者是否接受阿卡波糖治疗评估 CVD 结局的风险。所有患者均接受随访，以评估多因素干预的长期效果。在基线时，与 T2DM 中不接受阿卡波糖治疗的患者相比，接受阿卡波糖治疗的患者达到联合目标控制的比例没有显著差异。从第 8 年随访开始，接受阿卡波糖治疗的患者联合目标控制率显著高于不接受阿卡波糖治疗的患者。在 10 年随访期间，共发生 446 例终点事件，包括全因死亡、心血管事件、脑血管事件。接受阿卡波糖治疗的患者心肌梗死（从第 4 年随访开始）和全因死亡（从第 2 年随访开始）的发生率明显低于不接受阿卡波糖治疗的患者。在 Cox 多变量分析中，两组在 10 年随访期间心肌梗死和全因死亡的发生率存在显著差异，调整后的 HR 分别为 0.50 和 0.52。经过多因素干预，接受阿卡波糖治疗的 T2DM 患者心肌梗死和全因死亡明显减少。阿卡波糖治疗对改善联合目标控制的长期效果可能是降低心肌梗死和全因死亡的主要原因之一。
ChiCTR-TRC-13003978，ChiCTR-OOC-15006090。
