Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA.
Department of Public Health Sciences, Loyola University Chicago Health Sciences Campus, Maywood, Illinois, USA.
J Diabetes. 2021 Dec;13(12):1043-1053. doi: 10.1111/1753-0407.13224. Epub 2021 Oct 11.
Studies have reported an association between prevalent cardiovascular disease (CVD) and risk of diabetes mellitus (DM). However, factors that may explain the association remain unclear. We examined the association of prevalent CVD with incident DM and assessed whether weight gain and medication use may explain the association.
Data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Visit 1 (2008-2011) and Visit 2 (2014-2017) were used to compare incidence of DM among individuals with and without self-reported CVD at Visit 1. A total of 1899 individuals with self-reported CVD were matched to controls free of self-reported CVD at Visit 1 using 1:1 propensity score matching. Covariates included in the propensity model were sociodemographic characteristics, lifestyle factors, comorbid conditions, and study site. The effect of self-reported CVD on incident DM was examined using a generalized estimating equation. The mediating effects of weight gain and use of cardiovascular medications were evaluated.
Covariate distributions were similar among individuals with and without self-reported CVD. The incidence of DM among persons with self-reported CVD was 15.3% vs 12.7% among those without self-reported CVD. Compared to individuals without self-reported CVD, individuals with self-reported CVD had a 24% increased risk for incident DM (odds ratio = 1.24, 95% confidence interval = 1.01, 1.51). The association between self-reported CVD and DM was mediated by the use of beta-blockers (proportion explained = 25.4%), statins (proportion explained = 18%), and diuretics (proportion explained = 8%). We found that weight gain did not explain the observed association.
Prevalent cardiovascular disease was associated with a significant increased risk of incident diabetes. The observed association was partially explained by some medications used to manage CVD.
已有研究报告称，现患心血管疾病（CVD）与糖尿病（DM）风险之间存在关联。然而，仍不清楚可能解释这种关联的因素。我们研究了现患 CVD 与新发 DM 的关联，并评估了体重增加和药物使用是否可能解释这种关联。
我们使用来自西班牙裔美国人社区健康研究/拉丁裔研究（HCHS/SOL）第一次访视（2008-2011 年）和第二次访视（2014-2017 年）的数据，比较了第一次访视时报告有 CVD 和没有报告有 CVD 的个体新发 DM 的发病率。共有 1899 名报告有 CVD 的个体与第一次访视时无报告有 CVD 的个体进行了 1:1 倾向评分匹配。纳入倾向模型的协变量包括社会人口统计学特征、生活方式因素、合并症和研究地点。使用广义估计方程检验报告有 CVD 对新发 DM 的影响。评估了体重增加和使用心血管药物的中介作用。
报告有 CVD 和无报告有 CVD 的个体之间的协变量分布相似。报告有 CVD 的个体新发 DM 的发病率为 15.3%，而无报告有 CVD 的个体为 12.7%。与无报告有 CVD 的个体相比，报告有 CVD 的个体新发 DM 的风险增加了 24%（比值比=1.24，95%置信区间=1.01，1.51）。报告有 CVD 与 DM 之间的关联部分由β受体阻滞剂（解释比例为 25.4%）、他汀类药物（解释比例为 18%）和利尿剂（解释比例为 8%）的使用所介导。我们发现体重增加并不能解释观察到的关联。
现患 CVD 与新发 DM 的风险显著增加相关。观察到的关联部分由一些用于治疗 CVD 的药物所解释。
