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2 型糖尿病患者的危险因素控制与心血管事件。

Risk factor control and cardiovascular events in patients with type 2 diabetes mellitus.

机构信息

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

出版信息

PLoS One. 2024 Feb 29;19(2):e0299035. doi: 10.1371/journal.pone.0299035. eCollection 2024.

Abstract

BACKGROUND

Since patients with type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular events, interventions addressing risk factors reduce the incidence of cardiovascular disease (CVD) events. This study aimed to evaluate the difference in the incidence of CVD events according to risk factor control in patients with diabetes with and without cardio-renal disease.

METHODS

We analyzed 113,909 patients with diabetes and 290,339 without diabetes using data released by the National Health Insurance Service (NHIS).

RESULTS

Among patients with diabetes with four or five poorly controlled risk factors, hazard ratio for CVD events was 1.19 (95% confidence interval [CI], 1.06-1.34) in patients with cardio-renal disease and 2.31 (95% CI, 1.95-2.74) in patients without cardio-renal disease compared to patients with diabetes without risk factors. In subjects with diabetes and cardio-renal disease, patients with four or five poorly controlled risk factors had a higher risk of CVD mortality compared to subjects without risk factors (hazard ratio, 1.64; 95% CI, 1.18-2.30).

CONCLUSION

Controlling cardiovascular risk factors reduced the incidence of CVD events in patients with diabetes, especially those without cardio-renal disease. The degree of risk control was strongly associated with CVD mortality in patients with diabetes with baseline cardio-renal disease.

摘要

背景

由于 2 型糖尿病(T2DM)患者发生心血管事件的风险增加,因此针对风险因素的干预措施可降低心血管疾病(CVD)事件的发生率。本研究旨在评估有和无心肾疾病的糖尿病患者,根据危险因素控制情况,CVD 事件的发生率有无差异。

方法

我们使用国民健康保险服务(NHIS)发布的数据,对 113909 例糖尿病患者和 290339 例非糖尿病患者进行了分析。

结果

在伴有四或五项控制不佳的危险因素的糖尿病患者中,与无危险因素的患者相比,伴有心肾疾病的患者 CVD 事件的风险比为 1.19(95%置信区间[CI],1.06-1.34),而无心肾疾病的患者为 2.31(95%CI,1.95-2.74)。在伴有心肾疾病的糖尿病患者中,与无危险因素的患者相比,伴有四或五项控制不佳的危险因素的患者 CVD 死亡率更高(风险比,1.64;95%CI,1.18-2.30)。

结论

控制心血管危险因素可降低糖尿病患者的 CVD 事件发生率,尤其是无心肾疾病的患者。在伴有心肾疾病的糖尿病患者中,风险控制程度与 CVD 死亡率密切相关。

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