Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Diabetes Obes Metab. 2024 Jul;26(7):2673-2683. doi: 10.1111/dom.15583. Epub 2024 Apr 1.
To investigate the association between cardiovascular health metrics defined by Life's Essential 8 (LE8) scores and vascular complications among individuals with type 2 diabetes (T2D).
This prospective study included 11 033 participants with T2D, all devoid of macrovascular diseases (including cardiovascular and peripheral artery disease) and microvascular complications (e.g. diabetic retinopathy, neuropathy and nephropathy) at baseline from the UK Biobank. The LE8 score comprised eight metrics: smoking, body mass index, physical activity, non-high-density lipoprotein cholesterol, blood pressure, glycated haemoglobin, diet and sleep duration. Cox proportional hazards models were established to assess the associations of LE8 scores with incident macrovascular and microvascular complications.
During a median follow-up of 12.1 years, we identified 1975 cases of incident macrovascular diseases and 1797 cases of incident microvascular complications. After adjusting for potential confounders, each 10-point increase in the LE8 score was associated with an 18% lower risk of macrovascular diseases and a 15% lower risk of microvascular complications. Comparing individuals in the highest and lowest quartiles of LE8 scores revealed hazard ratios of 0.55 (95% confidence interval 0.47-0.62) for incident macrovascular diseases, and 0.61 (95% confidence interval 0.53-0.70) for incident microvascular complications. This association remained robust across a series of sensitivity analyses and nearly all subgroups.
Higher LE8 scores were associated with a lower risk of incident macrovascular and microvascular complications among individuals with T2D. These findings underscore the significance of adopting fundamental strategies to maintain optimal cardiovascular health and curtail the risk of developing diabetic vascular complications.
探讨由生命必需 8 项（LE8）评分定义的心血管健康指标与 2 型糖尿病（T2D）患者血管并发症之间的关系。
本前瞻性研究纳入了来自英国生物库的 11033 名无大血管疾病（包括心血管疾病和外周动脉疾病）和微血管并发症（如糖尿病视网膜病变、神经病变和肾病）的 T2D 患者。LE8 评分包括八项指标：吸烟、体重指数、身体活动、非高密度脂蛋白胆固醇、血压、糖化血红蛋白、饮食和睡眠时间。建立 Cox 比例风险模型评估 LE8 评分与新发大血管和微血管并发症的关联。
在中位随访 12.1 年期间，我们确定了 1975 例新发大血管疾病和 1797 例新发微血管并发症。在调整了潜在混杂因素后，LE8 评分每增加 10 分，大血管疾病的风险降低 18%，微血管并发症的风险降低 15%。比较 LE8 评分最高和最低四分位数的个体，新发大血管疾病的风险比为 0.55（95%置信区间 0.47-0.62），新发微血管并发症的风险比为 0.61（95%置信区间 0.53-0.70）。这种关联在一系列敏感性分析和几乎所有亚组中仍然稳健。
在 T2D 患者中，较高的 LE8 评分与新发大血管和微血管并发症风险降低相关。这些发现强调了采取基本策略来维持最佳心血管健康并降低发生糖尿病血管并发症风险的重要性。
