Wang Yaxin, Bulloch Gabriella, Huang Yu, Liang Yingying, Du Zijing, Wu Guanrong, Fang Ying, Hu Yijun, Shang Xianwen, Zhu Zhuoting, Zhang Xiayin, Yang Xiaohong, Yu Honghua
Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.
Diabetol Metab Syndr. 2023 Aug 29;15(1):178. doi: 10.1186/s13098-023-01152-4.
To evaluate the association of atherosclerotic cardiovascular disease (ASCVD) risk factors with incident ASCVD events among type 2 diabetes (T2D) individuals with microvascular complications.
We included T2D participants with only microvascular complications from the UK Biobank cohort at baseline (2006-2010). Multivariable-adjusted Cox proportional hazards models were used to study the association between ASCVD risk factors with adjudicated incident ASCVD in T2D participants with only microvascular complications. A restricted cubic spline approach was employed to evaluate potential nonlinear associations between ASCVD risk factors and ASCVD.
We studied 4,129 T2D individuals with microvascular complications at baseline. Over a median follow-up of 11.7 years, a total of 1,180 cases of incident ASCVD were documented, of which 1,040 were CHD, 100 were stroke, and 40 were both CHD and stroke events. After multivariable-adjustment, high-density lipoprotein cholesterol (HDL-C) level was linearly associated with a decreased risk of incident ASCVD [hazard ratio (HR): 0.49, 95% Confidence interval (CI): 0.32-0.75, P = 0.011] and each 10 nmol/L increase of lipoprotein(a) [Lp(a)] level (HR: 1.02, 95% CI: 1.00-1.04, P = 0.012) was linearly associated with an increased risk of incident ASCVD in T2D participants with only microvascular complications.
HDL-C levels and Lp(a) levels (per 10 nmol/L) showed an independent linear relation with ASCVD risk among T2D individuals with only microvascular complications at long-term follow-up.
评估在患有微血管并发症的2型糖尿病（T2D）个体中，动脉粥样硬化性心血管疾病（ASCVD）危险因素与ASCVD事件发生之间的关联。
我们纳入了英国生物银行队列中基线时（2006 - 2010年）仅患有微血管并发症的T2D参与者。采用多变量调整的Cox比例风险模型，研究仅患有微血管并发症的T2D参与者中ASCVD危险因素与经判定的ASCVD事件发生之间的关联。采用受限立方样条法评估ASCVD危险因素与ASCVD之间的潜在非线性关联。
我们研究了基线时4129例患有微血管并发症 的T2D个体。在中位随访11.7年期间，共记录到1180例ASCVD事件，其中1040例为冠心病，100例为中风，40例为冠心病和中风事件。多变量调整后，高密度脂蛋白胆固醇（HDL-C）水平与ASCVD事件发生风险降低呈线性相关[风险比（HR）：0.49，95%置信区间（CI）：0.32 - 0.75，P = 0.011]，并且在仅患有微血管并发症的T2D参与者中，脂蛋白（a）[Lp（a）]水平每升高每10 nmol/L（HR：1.02，95% CI：1.00 - 1.04，P = 0.012）与ASCVD事件发生风险增加呈线性相关。
在长期随访中，HDL-C水平和Lp（a）水平（每10 nmol/L）在仅患有微血管并发症的T2D个体中与ASCVD风险呈现独立的线性关系。
