Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Spitalstrasse 26, 4056, Basel, Switzerland.
Hospital Pharmacy, University Hospital Basel, Basel, Switzerland.
Cardiovasc Diabetol. 2022 Jan 4;21(1):2. doi: 10.1186/s12933-021-01432-1.
Previous studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glycemic control and the risk of unprovoked (idiopathic) VTE in men and women with T2DM.
We conducted a nested case-control analysis (1:4 matching) within a cohort of patients with incident T2DM between 1995 and 2019 using data from the CPRD GOLD. We excluded patients with known risk factors for VTE prior to onset of DM. Cases were T2DM patients with an unprovoked treated VTE. The exposure of interest was glycemic control measured as HbA1c levels. We conducted conditional logistic regression analyses adjusted for several confounders.
We identified 2'653 VTE cases and 10'612 controls (53.1% females). We found no association between the HbA1c level and the risk of VTE in our analyses. However, when the most recent HbA1c value was recorded within 90 days before the index date, women with HbA1c levels > 7.0% had a 36-55% increased relative risk of VTE when compared to women with HbA1c > 6.5-7.0%.
Our study raises the possibility that female T2DM patients with HbA1c levels > 7% may have a slightly higher risk for unprovoked VTE compared to women with HbA1c levels > 6.5-7.0%. This increase may not be causal and may reflect differences in life style or other characteristics. We observed no effect of glycemic control on the risk of VTE in men.
先前的研究表明，2 型糖尿病（T2DM）患者发生静脉血栓栓塞（VTE）的风险升高，且可能存在性别差异。血糖控制对 VTE 风险的影响尚不清楚。我们的目的是分析血糖控制与 T2DM 男性和女性发生自发性（特发性）VTE 风险之间的关系。
我们使用来自 CPRD GOLD 的数据，对 1995 年至 2019 年间发生的 T2DM 患者队列进行了嵌套病例对照分析（1:4 匹配）。我们排除了在糖尿病发病前已知存在 VTE 危险因素的患者。病例为 T2DM 患者，且发生自发性治疗的 VTE。感兴趣的暴露因素是糖化血红蛋白（HbA1c）水平。我们进行了调整了多个混杂因素的条件逻辑回归分析。
我们确定了 2653 例 VTE 病例和 10612 例对照（53.1%为女性）。我们的分析未发现 HbA1c 水平与 VTE 风险之间存在关联。然而，当最近一次 HbA1c 值记录在索引日期前 90 天内时，HbA1c>7.0%的女性与 HbA1c>6.5-7.0%的女性相比，VTE 的相对风险增加了 36-55%。
我们的研究提出了一种可能性，即 HbA1c>7%的女性 T2DM 患者与 HbA1c>6.5-7.0%的女性相比，可能有稍高的自发性 VTE 风险。这种增加可能不是因果关系，可能反映了生活方式或其他特征的差异。我们观察到血糖控制对男性 VTE 风险没有影响。
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