扳机指与 2 型糖尿病患者心血管疾病发病风险相关：一项回顾性队列研究。
Trigger finger is associated with risk of incident cardiovascular disease in individuals with type 2 diabetes: a retrospective cohort study.
机构信息
Department of Internal Medicine, Otsu City Hospital, Otsu, Shiga, Japan.
Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
出版信息
BMJ Open Diabetes Res Care. 2021 Apr;9(1). doi: 10.1136/bmjdrc-2020-002070.
INTRODUCTION
Trigger finger is one of the complications affecting the upper extremity in patients with diabetes. Diabetes is also a well-known risk factor that predisposes individuals to cardiovascular diseases (CVDs). This retrospective cohort study aimed to establish the association between trigger finger and the patients with incident CVD with type 2 diabetes.
MATERIALS AND METHODS
Trigger finger was diagnosed by palpating a thickened tendon during flexion or on the manifestation of a locking phenomenon during extension or flexion of either finger. The relationship between trigger finger and other clinical parameters or complications of diabetes was examined by a comparative analysis. Cox regression analysis was used to evaluate the association between trigger finger and incidence of CVD. We calculated the propensity scores using sex, body mass index, age, smoking status, duration of diabetes, estimated glomerular filtration rate, hypertension, dyslipidemia, and hemoglobin A1c as the number of patients with incident CVD during the follow-up period was low.
RESULTS
Among the 399 patients with type 2 diabetes, 54 patients had trigger finger. Patients with trigger finger were significantly older in age and had been suffering from diabetes for a longer duration. They also displayed worse renal function and glycemic control, along with a higher incidence of hypertension, neuropathy and nephropathy. During the average 5.66±1.12 years of follow-up, a total of 18 incidents occurred. According to the Cox regression analysis, trigger finger was shown to be associated with enhanced risk of the incidence of CVD after adjustment for the covariates (adjusted HR=3.33 (95% CI 1.25 to 8.66), p=0.017).
CONCLUSIONS
Trigger finger is associated with the risk of incident CVD in patients with type 2 diabetes. Thus, clinicians must consider these factors at the time of diagnosis of such patients.
简介
扳机指是影响糖尿病患者上肢的并发症之一。糖尿病也是已知的易患心血管疾病（CVD）的危险因素。本回顾性队列研究旨在确定 2 型糖尿病伴发扳机指与新发 CVD 患者之间的关联。
材料和方法
通过在手指弯曲时触诊增厚的肌腱，或在伸展或弯曲时出现锁定现象来诊断扳机指。通过比较分析检查扳机指与其他临床参数或糖尿病并发症之间的关系。使用 Cox 回归分析评估扳机指与 CVD 发生率之间的关联。由于在随访期间新发 CVD 的患者数量较低，因此我们使用性别、体重指数、年龄、吸烟状况、糖尿病病程、估计肾小球滤过率、高血压、血脂异常和糖化血红蛋白作为协变量计算倾向评分。
结果
在 399 例 2 型糖尿病患者中，有 54 例患有扳机指。患有扳机指的患者年龄明显较大，且糖尿病病程较长。他们的肾功能和血糖控制也较差，同时高血压、神经病变和肾病的发生率也较高。在平均 5.66±1.12 年的随访期间，共发生了 18 例事件。根据 Cox 回归分析，在校正协变量后，扳机指与 CVD 发生率增加相关（调整后的 HR=3.33（95%CI 1.25 至 8.66），p=0.017）。
结论
扳机指与 2 型糖尿病患者新发 CVD 的风险相关。因此，临床医生在诊断此类患者时必须考虑这些因素。
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