Chellaram Diabetes Institute, Pune, India.
Department of Endocrinology, Osmania Medical College, Osmania General Hospital, Hyderabad, India.
PLoS One. 2022 Mar 31;17(3):e0263619. doi: 10.1371/journal.pone.0263619. eCollection 2022.
Type 2 diabetes mellitus (T2DM) worldwide continues to increase, in particular in India. Early T2DM diagnosis followed by appropriate management will result in more cardiovascular event free life years. However, knowledge of the cardiovascular profile of newly diagnosed T2DM patients is still limited. The aim of this study was to understand the extent of cardiovascular disease (CVD) risk of newly diagnosed T2DM patients in India.
A cross sectional observational study was conducted to evaluate clinical laboratory and socio-demographic parameters of 5,080 newly diagnosed T2DM patients (48.3 ± 12.8 years of age; 36.7% female). In addition, we determined their cardiovascular risk according to the guidelines of the Lipid Association of India (LAI) and the criteria of the QRISK3 score.
Of the newly T2DM diagnosed patients in India 2,007(39.5%) were classified as "High risk" and 3,073 (60.5%) were classified as "Very high risk" based on LAI criteria. On average, patients had 1.7 ± 0.9 major atherosclerotic cardiovascular disease (ASCVD) risk factors. Low HDL-C value was the most frequent major risk (2,823; 55.6%) followed by high age (2,502; 49.3%), hypertension (2,141; 42.1%), smoking/tobacco use (1,078; 21.2%) and chronic kidney disease stage 3b or higher (568; 11.2%). In addition, 4,192 (82.5%) patients appeared to have at least one cholesterol abnormality and, if the latest LAI recommendations are applied, 96.5% (4,902) presented with lipid values above recommended targets. Based on the QRISK3 calculation Indian diabetes patients had an average CVD risk of 15.3 ± 12.3%, (12.2 ± 10.1 vs. 17.1 ± 13.5 [p<0.001] for females and males, respectively).
Newly diagnosed Indian T2DM patients are at high ASCVD risk. Our data therefore support the notion that further extension of nationwide ASCVD risk identification programs and prevention strategies to reduce the occurrence of cardiovascular diseases are warranted.
2 型糖尿病（T2DM）在全球范围内持续增加，尤其是在印度。早期诊断 T2DM 并进行适当的管理，将导致更多的无心血管事件的生命年。然而，新诊断的 T2DM 患者的心血管特征仍知之甚少。本研究的目的是了解印度新诊断的 T2DM 患者的心血管疾病（CVD）风险程度。
进行了一项横断面观察性研究，评估了 5080 名新诊断的 T2DM 患者（48.3±12.8 岁；36.7%为女性）的临床实验室和社会人口统计学参数。此外，我们根据印度脂质协会（LAI）指南和 QRISK3 评分标准确定了他们的心血管风险。
在印度新诊断的 T2DM 患者中，根据 LAI 标准，有 2007 名（39.5%）患者被归类为“高风险”，3073 名（60.5%）患者被归类为“极高风险”。平均每位患者有 1.7±0.9 个主要动脉粥样硬化性心血管疾病（ASCVD）危险因素。低 HDL-C 值是最常见的主要风险（2823 例；55.6%），其次是高龄（2502 例；49.3%）、高血压（2141 例；42.1%）、吸烟/使用烟草（1078 例；21.2%）和慢性肾脏病 3b 期或更高级别（568 例；11.2%）。此外，4192 名（82.5%）患者至少有一种胆固醇异常，如果应用最新的 LAI 建议，96.5%（4902 名）患者的血脂值超过推荐目标。根据 QRISK3 计算，印度糖尿病患者的平均 CVD 风险为 15.3±12.3%（女性分别为 12.2±10.1%和 17.1±13.5%[p<0.001]）。
新诊断的印度 T2DM 患者存在高 ASCVD 风险。因此，我们的数据支持这样一种观点，即需要进一步扩大全国范围内的 ASCVD 风险识别计划和预防策略，以减少心血管疾病的发生。
