超重或肥胖的糖尿病前期患者冠状动脉钙化的危险因素：它们能否预测2型糖尿病和冠状动脉血管事件？

Risk Factors for Coronary Artery Calcifications in Overweight or Obese Persons with Prediabetes: Can They Predict T2 Diabetes and Coronary Vascular Events?

作者信息

Marjanovic Petkovic Milica, Vuksanovic Miljanka, Sagic Dragan, Radovic Ivana, Soldatovic Ivan, Beljic Zivkovic Teodora

机构信息

Division of Endocrinology Diabetes and Metabolic Disorders, Zvezdara University Medical Center, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia.

Cardiovascular Institute Dedinje, Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia.

出版信息

J Clin Med. 2023 Jun 8;12(12):3915. doi: 10.3390/jcm12123915.

DOI:10.3390/jcm12123915

PMID:37373609

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10299489/

Abstract

BACKGROUND

It is difficult to predict the risk of developing atherosclerotic cardiovascular disease in subjects with prediabetes and obesity. The aim of this study was to assess risk factors for coronary artery calcifications (CACs) and the development of type 2 diabetes (T2D) and coronary vascular events (CVEs) after 7 years in 100 overweight or obese persons with prediabetes, according to the baseline coronary artery calcium score (CACS).

METHODS

Lipids, HbA1c, uric acid, and creatinine were assessed. Glucose, insulin, and c-peptide were determined during an oral glucose tolerance test. Multi-sliced computerized tomography with evaluation of CACS was performed. After 7 years, the subjects were assessed for T2D/CVE.

RESULTS

CACs were present in 59 subjects. No single biochemical marker could predict presence of a CAC. After 7 years, T2D developed in 55 subjects (61.8% initially had both IFG and IGT). A gain in weight was the only contributing factor for T2D. Nineteen subjects developed a CVE; increased initial clustering of HOMA-IR > 1.9, LDL > 2.6, and mmol/Land TGL > 1.7 mmol/L and higher CACS were present in that group.

CONCLUSIONS

No risk factors for CACs could be identified. A gain in weight is associated with T2D development, as are higher CACS and clustering of high LDL+TGL+HOMA-IR with CVEs.

摘要

背景

预测糖尿病前期和肥胖受试者发生动脉粥样硬化性心血管疾病的风险具有一定难度。本研究旨在根据基线冠状动脉钙化评分（CACS），评估100例超重或肥胖的糖尿病前期患者7年后冠状动脉钙化（CAC）、2型糖尿病（T2D）的发生及冠状动脉血管事件（CVE）的危险因素。

方法

评估血脂、糖化血红蛋白、尿酸和肌酐水平。在口服葡萄糖耐量试验期间测定血糖、胰岛素和C肽水平。进行多层计算机断层扫描以评估CACS。7年后，对受试者进行T2D/CVE评估。

结果

59例受试者存在CAC。没有单一的生化标志物能够预测CAC的存在。7年后，55例受试者发生T2D（61.8%最初同时患有空腹血糖受损和糖耐量受损）。体重增加是T2D的唯一促成因素。19例受试者发生了CVE；该组患者存在较高的初始HOMA-IR>1.9、低密度脂蛋白>2.6 mmol/L和甘油三酯>1.7 mmol/L聚集以及较高的CACS。