Drobek Natalia, Sowa Paweł, Jankowski Piotr, Haberka Maciej, Gąsior Zbigniew, Kosior Dariusz, Czarnecka Danuta, Pająk Andrzej, Szostak-Janiak Karolina, Krzykwa Agnieszka, Setny Małgorzata, Kozieł Paweł, Paniczko Marlena, Jamiołkowski Jacek, Kowalska Irina, Kamiński Karol
Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-089 Białystok, Poland.
Department of Cardiology, University Hospital of Bialystok, 15-276 Białystok, Poland.
J Clin Med. 2021 May 5;10(9):1981. doi: 10.3390/jcm10091981.
Dysglycemia is a public health challenge for the coming decades, especially in patients with chronic coronary syndromes (CCS). We want to assess the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes, as well as identify factors associated with the development of dysglycaemia in patients with CCS. In total, 1233 study participants (mean age 69 ± 9 years), who, between 6 and 18 months earlier were hospitalized for acute coronary syndrome or elective revascularization, were examined (71.4% men). The diagnosis of DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) have been made according to World Health Organization (WHO) criteria. Based on the oral glucose tolerance test (OGTT) results, DM has been newly diagnosed in 28 (5.1%, mean age 69.9 ± 8.4 years) patients, 75% were male ( = 21). Prediabetes has been observed in 395 (72.3%) cases. IFG was found in 234 (42.9%) subjects, 161 (29.5%) individuals had IGT. According to multinomial logistic regression, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) should be considered when assessing risk of development of dysglycaemia after discharge from the hospital. Among people with previously diagnosed DM, a significantly higher percentage were willing to change their lifestyles after the index event compared to other patients. Patients with chronic coronary syndromes suffer a very high frequency of dysglycaemia. Most patients with chronic coronary syndromes, especially those with high BMI or low HDL-C, should be considered for screening for dysglycemia using OGTT within the first year after hospitalization. A higher percentage of patients who were aware of their diabetic status changed their lifestyles, which added the benefit of timely diagnosis and treatment of diabetes.
血糖异常是未来几十年的一项公共卫生挑战,尤其是在慢性冠状动脉综合征(CCS)患者中。我们希望评估未诊断出的糖尿病(DM)和糖尿病前期的患病率,并确定与CCS患者血糖异常发生相关的因素。总共对1233名研究参与者(平均年龄69±9岁)进行了检查,这些参与者在6至18个月前因急性冠状动脉综合征或择期血运重建而住院(男性占71.4%)。根据世界卫生组织(WHO)标准对DM、空腹血糖受损(IFG)、糖耐量受损(IGT)进行了诊断。根据口服葡萄糖耐量试验(OGTT)结果,28名(5.1%,平均年龄69.9±8.4岁)患者新诊断出DM,其中75%为男性(n = 21)。在395例(72.3%)病例中观察到糖尿病前期。在234名(42.9%)受试者中发现了IFG,161名(29.5%)个体存在IGT。根据多项逻辑回归分析,在评估出院后血糖异常发生风险时应考虑体重指数(BMI)和高密度脂蛋白胆固醇(HDL-C)。在先前诊断为DM的人群中,与其他患者相比,在索引事件后愿意改变生活方式的比例显著更高。慢性冠状动脉综合征患者血糖异常的发生率非常高。大多数慢性冠状动脉综合征患者,尤其是那些BMI高或HDL-C低的患者,应在住院后第一年内考虑使用OGTT进行血糖异常筛查。知晓自己糖尿病状态的患者中,有更高比例的人改变了生活方式,这增加了糖尿病及时诊断和治疗的益处。