Wang ChenChen, Xie ZuoLing, Huang Xi, Wang Zheng, ShangGuan HaiYan, Wang ShaoHua
Department of Endocrinology, The Affiliated Zhongda Hospital of Southeast University, Nanjing, China.
School of Medicine, Southeast University, Nanjing, China.
Curr Med Res Opin. 2022 Mar;38(3):345-354. doi: 10.1080/03007995.2021.2022382. Epub 2022 Jan 10.
Coronary heart disease (CHD) is the most common cause of death in patients with type 2 diabetes (T2DM). We aim to estimate the prevalence of CHD and cardiovascular risk factors in Chinese patients with T2DM.
A total of 66,536 inpatients with diabetes treated from 2013 to 2018 were investigated, and demographic and clinical data were collected from 30,693 patients with T2DM. Age-standardized prevalence of CHD was calculated on the basis of data from the Chinese population census in 2010. Logistic regression analysis was used to analyze the risk factors.
The crude prevalence of CHD was estimated to be 23.5% and a standardized prevalence was 13.9% (16.0% in men and 11.9% in women). More than half of patients with CHD have four or more of the five traditional risk factors, much higher than the 38.96% of patients without CHD ( < .01). Multivariate regression analysis showed that diabetes duration, hypertension, smoking, underweight, overweight, obesity and hypoglycaemia were significantly associated with increased risk of CHD (all < .05). The odds ratio of CHD in patients with three, four or five defined CHD risk factors (i.e. diabetes, hypertension, dyslipidaemia, overweight or obese, and smoking) were 2.35 (95% CI 1.81-3.04), 2.96 (95% CI 2.28-3.85) or 5.29 (95% CI 4.04-6.93), compared with diabetes patients without any other risk factors.
The prevalence of CHD was rather high in Chinese T2DM inpatients, and the aggregation of CHD risk factors was severe. Thus, hierarchical CHD prevention strategies based on risk factors are necessary.
冠心病（CHD）是2型糖尿病（T2DM）患者最常见的死亡原因。我们旨在估算中国T2DM患者中冠心病的患病率及心血管危险因素。
对2013年至2018年期间接受治疗的66536例糖尿病住院患者进行调查，并收集了30693例T2DM患者的人口统计学和临床数据。基于2010年中国人口普查数据计算冠心病的年龄标准化患病率。采用逻辑回归分析来分析危险因素。
冠心病的粗患病率估计为23.5%，标准化患病率为13.9%（男性为16.0%，女性为11.9%）。超过一半的冠心病患者具有五种传统危险因素中的四种或更多种，远高于无冠心病患者的38.96%（P<0.01）。多因素回归分析显示，糖尿病病程、高血压、吸烟、体重过轻、超重、肥胖和低血糖与冠心病风险增加显著相关（均P<0.05）。与无任何其他危险因素的糖尿病患者相比，具有三种、四种或五种既定冠心病危险因素（即糖尿病、高血压、血脂异常、超重或肥胖以及吸烟）的患者患冠心病的比值比分别为2.35（95%CI 1.81-3.04）、2.96（95%CI 2.28-3.85）或5.29（95%CI 4.04-6.93）。
中国T2DM住院患者中冠心病患病率相当高，且冠心病危险因素聚集严重。因此，有必要基于危险因素制定分层冠心病预防策略。
