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评估心胸比作为 2 型糖尿病患者心血管异常的潜在预测指标:一项病例对照研究。

Evaluation of cardiothoracic ratio as a potential predictor of cardiovascular abnormalities in individuals with type II diabetes mellitus: a case-control study.

机构信息

Department of Basic Medical Science, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.

Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt.

出版信息

J Med Life. 2024 Jul;17(7):739-745. doi: 10.25122/jml-2024-0029.

DOI:10.25122/jml-2024-0029
PMID:39440336
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11493163/
Abstract

Cardiovascular complications represent a significant health concern for individuals with diabetes mellitus. The relationship between diabetes and cardiovascular diseases is complex and multifaceted, involving a variety of pathophysiological mechanisms. This study aimed to investigate the potential role of the cardiothoracic ratio as a prognostic tool for cardiovascular disorders in patients with diabetes. A retrospective case-control study of 530 adult patients referred to a tertiary care hospital in Saudi Arabia was conducted. Medical records, including chest X-rays, were analyzed to determine the cardiothoracic ratio. Patients diagnosed with diabetes who experienced cardiac disorders had significantly higher cardiothoracic ratios compared to patients with diabetes alone and controls. HbA1c was significantly elevated among patients with diabetes and cardiovascular disorders (mean = 71.5 ± 25.43 mmol/mol) compared to the other patients. There was a significant positive correlation between the duration of diabetes and the cardiothoracic ratio (r = 0.64, < 0.001). Furthermore, the cardiothoracic ratio above 0.51 was a good discriminator of cardiovascular disorders in patients with diabetes, with an area under the curve of 0.737, sensitivity of 97.1%, and specificity of 87.2%. This study provided comprehensive evidence supporting the association between cardiothoracic ratio and subsequent cardiovascular adverse outcomes in patients with diabetes. We recommend adopting the cardiothoracic ratio as a valuable prognostic tool for risk stratification among people with diabetes.

摘要

心血管并发症是糖尿病患者的一个重大健康问题。糖尿病与心血管疾病之间的关系复杂且多方面,涉及多种病理生理机制。本研究旨在探讨心胸比作为预测糖尿病患者心血管疾病的预后工具的潜力。对沙特阿拉伯一家三级保健医院的 530 名成年患者进行了回顾性病例对照研究。分析了包括胸部 X 光在内的病历,以确定心胸比。与单纯糖尿病患者和对照组相比,患有糖尿病且发生心脏疾病的患者的心胸比显著更高。与其他患者相比,患有糖尿病和心血管疾病的患者的 HbA1c 显著升高(平均值 = 71.5 ± 25.43mmol/mol)。糖尿病患者的糖尿病病程与心胸比之间存在显著的正相关关系(r = 0.64, < 0.001)。此外,心胸比大于 0.51 是糖尿病患者发生心血管疾病的良好预测指标,曲线下面积为 0.737,灵敏度为 97.1%,特异性为 87.2%。本研究提供了全面的证据,支持心胸比与糖尿病患者随后发生心血管不良结局之间的关联。我们建议采用心胸比作为糖尿病患者风险分层的有价值的预后工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/b838b3f28310/JMedLife-17-739-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/b9f50c30d56f/JMedLife-17-739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/e6b0151fcbea/JMedLife-17-739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/131666ed48f4/JMedLife-17-739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/52dbef6a7b2d/JMedLife-17-739-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/b838b3f28310/JMedLife-17-739-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/b9f50c30d56f/JMedLife-17-739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/e6b0151fcbea/JMedLife-17-739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/131666ed48f4/JMedLife-17-739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/52dbef6a7b2d/JMedLife-17-739-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed6/11493163/b838b3f28310/JMedLife-17-739-g005.jpg

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Commun Med (Lond). 2023 Feb 7;3(1):19. doi: 10.1038/s43856-023-00241-9.
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Duration of diabetes and the risk of major cardiovascular events in women and men: A prospective cohort study of UK Biobank participants.糖尿病病程与女性和男性主要心血管事件风险:英国生物库参与者的前瞻性队列研究。
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Int J Mol Sci. 2022 Mar 25;23(7):3587. doi: 10.3390/ijms23073587.
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