根据血糖状况评估理想心血管健康及其变化与亚临床动脉粥样硬化的关系：一项前瞻性队列研究。

The association of ideal cardiovascular health and its change with subclinical atherosclerosis according to glucose status: A prospective cohort study.

机构信息

Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

J Diabetes. 2024 Oct;16(10):e70007. doi: 10.1111/1753-0407.70007.

DOI:10.1111/1753-0407.70007

PMID:39387213

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11464993/

Abstract

BACKGROUND

An updated definition was developed to better evaluate cardiovascular health (CVH). We aimed to investigate whether optimal or improvement of six CVH metrics defined by new Life's Essential 8 (LE8) may counteract the risk of subclinical atherosclerosis among patients with hyperglycemia.

METHODS

We conducted a prospective analysis of 5225 participants without prior cardiovascular diseases, of whom 4768 had complete data on CVH change. Subjects with CVH scores of 0-49, 50-79, and 80-100 points were categorized as having low, moderate, or high CVH, respectively. Subclinical atherosclerosis was evaluated by brachial-ankle pulse wave velocity, pulse pressure and albuminuria, both separately and in combination.

RESULTS

Of the 5225 participants, 1937 (37.1%) had normal glucose regulation, while 3288 (62.9%) had hyperglycemia. The multivariable-adjusted odds ratio (OR) for composite subclinical atherosclerosis was 2.34 (95% confidence interval [CI], 1.88-2.91), 1.43 (95% CI, 1.21-1.70), and 0.74 (95% CI, 0.46-1.18), for participants with hyperglycemia who had low, moderate, or high overall CVH scores, respectively, compared with participants with normal glucose regulation. In addition, compared with those with stable CVH and normal glucose regulation, participants who exhibited greater improvements in overall CVH from 2010 to 2014 had a reduced risk of composite subclinical atherosclerosis with an OR of 0.72 (95% CI, 0.53-0.98) for those with normal glucose regulation, and 1.13 (95% CI, 0.87-1.48) for those with hyperglycemia.

CONCLUSIONS

The novel defined CVH using six metrics was inversely associated with subsequent risk of subclinical atherosclerosis. Both the status of CVH and its changes modified the relationship between hyperglycemia and subclinical atherosclerosis.

摘要

背景

为了更好地评估心血管健康（CVH），提出了一个更新的定义。我们旨在研究新的生命八大要素（LE8）中定义的六个 CVH 指标是否可以改善或优化，是否可以抵消高血糖患者亚临床动脉粥样硬化的风险。

方法

我们对 5225 名无心血管疾病史的参与者进行了前瞻性分析，其中 4768 名有完整的 CVH 变化数据。CVH 评分分别为 0-49、50-79 和 80-100 的受试者被归类为低、中或高 CVH。亚临床动脉粥样硬化通过肱踝脉搏波速度、脉压和白蛋白尿来评估，同时单独和联合评估。

结果

在 5225 名参与者中，1937 名（37.1%）血糖调节正常，3288 名（62.9%）血糖异常。多变量校正后，血糖异常患者复合亚临床动脉粥样硬化的比值比（OR）分别为 2.34（95%置信区间[CI]，1.88-2.91）、1.43（95%CI，1.21-1.70）和 0.74（95%CI，0.46-1.18），与血糖调节正常的参与者相比，整体 CVH 评分分别为低、中、高的患者。此外，与稳定的 CVH 和血糖调节正常的患者相比，2010 年至 2014 年整体 CVH 改善更大的患者发生复合亚临床动脉粥样硬化的风险降低，OR 分别为 0.72（95%CI，0.53-0.98），血糖调节正常的患者，和 1.13（95%CI，0.87-1.48），血糖异常的患者。