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Lancet Diabetes Endo:发生微血管病变的2型糖尿病患者发生心血管病风险增加

2016-05-21 MedSci MedSci原创

背景糖尿病使民众患心血管疾病的风险翻倍,然而预测个民众的个体风险仍然具有挑战性。糖尿病患者出现的微血管病变对其患心血管疾病的风险尚无人知晓。 方法 该研究是以人群为基础的队列研究,参与者为参与CPRD研究中的2型糖尿病患者(n = 49027)。研究人员使用多变量Cox模型来计算参与者发生主要结果(指既往没有心血管病史的患者因视网膜病变、肾脏病变、周围神经病变等多重出现心血管病性死亡、非致死性心肌

背景

糖尿病使民众患心血管疾病的风险翻倍,然而预测个民众的个体风险仍然具有挑战性。糖尿病患者出现的微血管病变对其患心血管疾病的风险尚无人知晓。

方法

该研究是以人群为基础的队列研究,参与者为参与CPRD研究中的2型糖尿病患者(n = 49027)。研究人员使用多变量Cox模型来计算参与者发生主要结果(指既往没有心血管病史的患者因视网膜病变、肾脏病变、周围神经病变等多重出现心血管病性死亡、非致死性心肌梗死或非致死性缺血性卒中)的风险比率(HRs)。

结果

平均随访时间为5.5年,共有2822名民众(占5.8%)发生了主要结果。 通过调整相关风险因素后,研究人员发现,视网膜病变(HR:1.39,95% CI:1.09-1.76)、周围神经病变(1.40,1.19-1.66)、肾脏病变(1.35, 1.15-1.58)等与主要结果的发生有密切关联。相比没有微血管病变的参与者而言,有1种、2种、3种微血管病变的民众出现主要结果的风险比分别1.32(95% CI:1.16-1.50)、1.62(1.42-1.85)和1.99(1.70-2.34)。若民众的微血管病变得以改善,则出现主要结果的发生率明显降低。在该队列研究中,美国和英国指南中的NRI分别为0.036(95%CI:0.017-0.055,p<0.0001)和0.038(0.013-0.060,p<0.0001)。

结论

研究表明,2型糖尿病患者若出现微血管病变,则出现心脏病、卒中和死亡的风险明显增加,研究人员认为他们仍需进行更进一步的研究已深入探究其内在机制。

原始出处:
Microvascular disease and risk of cardiovascular events among individuals with type 2 diabetes: a population-level cohort study,Dr Jack R W Brownrigg,et al,The Lancet Diabetes & Endocrinology,20,May,2016

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    2017-04-16 howi
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attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87208, encodeId=52e78e208ca, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87209, encodeId=42658e209cf, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=)]
  5. 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  6. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87206, encodeId=fb858e20695, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87207, encodeId=e0368e207d0, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=195, replyNumber=0, topicName=null, topicId=null, topicList=[], 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authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=)]
    2016-05-25 QQ6562edab

    学习?

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1637338, encodeId=8170163e33864, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Jul 12 06:49:00 CST 2016, time=2016-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901380, encodeId=baed1901380e9, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87206, encodeId=fb858e20695, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87207, encodeId=e0368e207d0, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=195, replyNumber=0, topicName=null, topicId=null, topicList=[], 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    2016-05-25 QQ6562edab

    学习?

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1637338, encodeId=8170163e33864, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Jul 12 06:49:00 CST 2016, time=2016-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901380, encodeId=baed1901380e9, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, 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encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Mon Jan 02 03:49:00 CST 2017, time=2017-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1644478, encodeId=fe0216444e824, content=<a href='/topic/show?id=e3eb89e17fb' target=_blank style='color:#2F92EE;'>#血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89717, encryptionId=e3eb89e17fb, topicName=血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=64bb23195917, createdName=Luyuxie_17, createdTime=Mon Sep 05 08:49:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87205, encodeId=c3568e20514, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87206, encodeId=fb858e20695, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87207, encodeId=e0368e207d0, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=195, replyNumber=0, topicName=null, topicId=null, topicList=[], 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    2016-05-25 QQ6562edab

    学习?

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87206, encodeId=fb858e20695, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87207, encodeId=e0368e207d0, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=195, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87208, encodeId=52e78e208ca, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/3B3BF0051F5289FA5E81ADFC54B1C14B/100, createdBy=27091728826, createdName=QQ6562edab, createdTime=Wed May 25 20:07:00 CST 2016, time=2016-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=87209, encodeId=42658e209cf, content=学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=146, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2016-05-25 QQ6562edab

    学习?

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1637338, encodeId=8170163e33864, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Jul 12 06:49:00 CST 2016, time=2016-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901380, encodeId=baed1901380e9, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, 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    2016-05-25 QQ6562edab

    学习?

    0

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