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绝经后女性的十年动脉粥样硬化性心血管疾病风险预测:孤立性餐后高血糖的影响。

Ten-year atherosclerotic cardiovascular disease risk prediction for postmenopausal women: Impacts of isolated postchallenge hyperglycemia.

机构信息

Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30352. doi: 10.1097/MD.0000000000030352.

Abstract

Isolated postchallenge hyperglycemia (IPH) is a type of diabetes mellitus defined as 2-h glucose ≥200 mg/dL but fasting glucose <126 mg/dL. The purpose of the study was to assess impacts of IPH on 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores in postmenopausal women. This study analyzed data from 428 postmenopausal women who underwent oral glucose tolerance test at a medical center. Ten-year ASCVD risk was evaluated by using Pooled Cohort Equations. Logistic regression analysis was performed to estimate odds ratios for having high 10-year ASCVD risk scores (≥5%) among these women. The subjects with IPH had higher systolic blood pressure and worse lipid profile than those without IPH. Ten-year ASCVD risk scores for postmenopausal women with IPH were calculated under 2 scenarios: the IPH women were considered non-diabetic, they were designated as patients with DM. The median ASCVD risk score of the participants with IPH increased significantly from 3.7% under scenario 1 to 7.1% under scenario 2. Approximately 20% women with IPH were re-categorized from risk category of <5% to ≥7.5% once they were identified as patients with DM (scenario 2). The results of logistic regression analyses showed that IPH was independently positively associated with 10-year ASCVD risk scores ≥5% under both scenarios. Postmenopausal women with IPH were characterized by unfavorable cardiovascular risk profile and high predicted 10-year ASCVD risk. Knowing the women's hidden DM status would significantly alter their risk categorization.

摘要

孤立性负荷后高血糖(IPH)是一种糖尿病,定义为 2 小时血糖≥200mg/dL,但空腹血糖<126mg/dL。本研究的目的是评估 IPH 对绝经后妇女 10 年动脉粥样硬化性心血管疾病(ASCVD)风险评分的影响。本研究分析了在一家医疗中心进行口服葡萄糖耐量试验的 428 名绝经后妇女的数据。使用汇总队列方程评估 10 年 ASCVD 风险。采用 logistic 回归分析估计这些女性中具有高 10 年 ASCVD 风险评分(≥5%)的比值比。与无 IPH 的女性相比,患有 IPH 的女性收缩压更高,血脂状况更差。在 2 种情况下计算了患有 IPH 的绝经后妇女的 10 年 ASCVD 风险评分:将 IPH 女性视为非糖尿病患者,将其指定为 DM 患者。参与者的 ASCVD 风险评分中位数从情景 1 下的 3.7%显著增加到情景 2 下的 7.1%。大约 20%的 IPH 女性一旦被确定为 DM 患者(情景 2),就从风险类别<5%重新分类为≥7.5%。logistic 回归分析结果表明,在两种情况下,IPH 与 10 年 ASCVD 风险评分≥5%均呈独立正相关。患有 IPH 的绝经后妇女具有不良心血管风险特征和高预测 10 年 ASCVD 风险。了解女性的隐性糖尿病状态会显著改变其风险分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54b3/10980439/0088df73bc79/medi-101-e30352-g001.jpg

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