家族性高胆固醇血症患者中糖尿病的患病率及其与动脉粥样硬化性心血管疾病风险的关联：来自希腊家族性高胆固醇血症登记处（HELLAS-FH）的分析
Prevalence of Diabetes and Its Association with Atherosclerotic Cardiovascular Disease Risk in Patients with Familial Hypercholesterolemia: An Analysis from the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH).
作者信息
Boutari Chrysoula, Rizos Christos V, Doumas Michalis, Liamis George, Skoumas Ioannis, Rallidis Loukianos, Garoufi Anastasia, Kolovou Genovefa, Tziomalos Konstantinos, Skalidis Emmanouil, Kotsis Vasileios, Sfikas George, Lambadiari Vaia, Anagnostis Panagiotis, Bilianou Eleni, Anastasiou Georgia, Koutagiar Iosif, Kiouri Estela, Attilakos Achilleas, Kolovou Vana, Zacharis Evangelos, Antza Christina, Liberopoulos Evangelos
机构信息
2nd Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece.
Department of Internal Medicine, Medical School, University of Ioannina, 45110 Ioannina, Greece.
出版信息
Pharmaceuticals (Basel). 2022 Dec 28;16(1):44. doi: 10.3390/ph16010044.
Familial hypercholesterolemia (FH) and type 2 diabetes mellitus (T2DM) are both associated with a high risk of atherosclerotic cardiovascular disease (ASCVD). Little is known about the prevalence of T2DM and its association with ASCVD risk in FH patients. This was a cross-sectional analysis from the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH) including adults with FH (n = 1719, mean age 51.3 ± 14.6 years). Of FH patients, 7.2% had a diagnosis of T2DM. The prevalence of ASCVD, coronary artery disease (CAD), and stroke was higher among subjects with T2DM compared with those without (55.3% vs. 23.3%, 48.8% vs. 20.7%, 8.3% vs. 2.7%, respectively, p < 0.001). When adjusted for age, systolic blood pressure, smoking, body mass index, hypertension, waist circumference, triglyceride levels, high-density lipoprotein cholesterol levels, and gender, T2DM was significantly associated with prevalent ASCVD [OR 2.0 (95% CI 1.2−3.3), p = 0.004]. FH patients with T2DM were more likely to have undergone coronary revascularization than those without (14.2% vs. 4.5% for coronary artery bypass graft, and 23.9% vs. 11.5% for percutaneous coronary intervention, p < 0.001). T2DM is associated with an increased risk for prevalent ASCVD in subjects with FH. This may have implications for risk stratification and treatment intensity in these patients.
家族性高胆固醇血症（FH）和2型糖尿病（T2DM）均与动脉粥样硬化性心血管疾病（ASCVD）的高风险相关。关于FH患者中T2DM的患病率及其与ASCVD风险的关联，目前所知甚少。这是一项来自希腊家族性高胆固醇血症登记处（HELLAS-FH）的横断面分析，纳入了成年FH患者（n = 1719，平均年龄51.3±14.6岁）。在FH患者中，7.2%被诊断为T2DM。与未患T2DM的患者相比，患T2DM的患者中ASCVD、冠状动脉疾病（CAD）和中风的患病率更高（分别为55.3%对23.3%、48.8%对20.7%、8.3%对2.7%，p<0.001）。在调整年龄、收缩压、吸烟、体重指数、高血压、腰围、甘油三酯水平、高密度脂蛋白胆固醇水平和性别后，T2DM与现患ASCVD显著相关[比值比2.0（95%可信区间1.2−3.3），p = 0.004]。与未患T2DM的FH患者相比，患T2DM的FH患者更有可能接受冠状动脉血运重建（冠状动脉搭桥术分别为14.2%对4.5%，经皮冠状动脉介入治疗分别为23.9%对11.5%，p<0.001）。T2DM与FH患者现患ASCVD风险增加相关。这可能对这些患者的风险分层和治疗强度有影响。
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