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Diabetes Care:降脂治疗可减少1型糖尿病患者CVD的发生及死亡风险

2016-04-26 MedSci MedSci原创

据发表于 Diabetes Care的一项新的研究显示,无心血管疾病史的1型糖尿病患者,降脂治疗或可降低其心血管疾病和心血管死亡的发生风险。

据发表于 Diabetes Care的一项新的研究显示,无心血管疾病史的1型糖尿病患者,降脂治疗或可降低其心血管疾病和心血管死亡的发生风险。

研究人员在文中写道,“降脂治疗后,整体人群的全因死亡和中风的风险几乎减半。”

来自瑞典哥德堡Sahlgrenska大学医院Christel Hero博士及其同事评估了2006-2008年瑞典国家糖尿病登记的数据,共包括24230名1型糖尿病患者,所有患者均无CVD病史。平均随访时间为6年。

其中18843名患者未经治疗, 5387名患者接受降脂治疗(97%使用他汀类药物)。研究人员欲确定降脂治疗对1型糖尿病患者心血管疾病发生和死亡的一级预防治疗的效果。

结果发现,与未治疗组相比,治疗组患者CVD的发生率高四倍左右。

在1:1匹配的4025名接受降脂治疗的患者与4025名未经治疗的患者中,治疗组致死/非致死性CVD的发生率为18.2/1000人年,未治疗组为17.3。但是,治疗组患者的全因死亡率明显低于未治疗组。

整个研究队列中,治疗组与未治疗组相比CVD死亡、全因死亡、致死/非致死性脑卒中、致死/非致死性急性心肌梗死以及致死/非致死性冠心病的HRs较为显著。匹配的队列中,只有全因死亡的HR较为显著。

“这项观察性研究表明,对于无心血管疾病史的1型糖尿病患者,降脂治疗可降低22-44% CVD的发病及死亡的风险,”研究人员写道,“该研究是第一项大型的观察性研究强调了降脂治疗在1型糖尿病患者初级预防中减少CVD发生风险中的重要性。”

原始出处:

Amber Cox. Lipid-lowering therapy reduces risk for CVD, death in type 1 diabetes. Healio, April 26, 2016.

Hero C, et al. Association Between Use of Lipid-Lowering Therapy and Cardiovascular Diseases and Death in Individuals With Type 1 Diabetes. Diabetes Care. 2016;doi:10.2337/dc15-2450.

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1968194, encodeId=3e131968194bc, content=<a href='/topic/show?id=a4b96e542' target=_blank style='color:#2F92EE;'>#1型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=675, encryptionId=a4b96e542, topicName=1型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Fri Dec 09 22:06:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637320, encodeId=df50163e3203e, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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=Sat Sep 17 23:06:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759662, encodeId=01341e596625b, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Tue Mar 14 14:06:00 CST 2017, time=2017-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901370, encodeId=d60c19013e002, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue Jan 24 11:06:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83454, encodeId=4d308345407, content=好研究,但是该研究97%是应用的他汀类药物,那么降低甘油三酯对1型糖尿病患者到底有没有益处呢?还是需要大规模研究进一步证实, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210704/cdd1076905df433c93873ae6d3d51aef/eae5c73864694494acb8435eb7d2e9bb.jpg, createdBy=ec7b92572, createdName=lshanp, createdTime=Sun May 01 16:15:00 CST 2016, time=2016-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255561, encodeId=d51b12555618a, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Thu Apr 28 14:06:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473970, encodeId=80a714e397050, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Apr 28 14:06:00 CST 2016, time=2016-04-28, status=1, ipAttribution=)]
    2016-05-01 lshanp

    好研究,但是该研究97%是应用的他汀类药物,那么降低甘油三酯对1型糖尿病患者到底有没有益处呢?还是需要大规模研究进一步证实

    0

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  7. [GetPortalCommentsPageByObjectIdResponse(id=1968194, encodeId=3e131968194bc, content=<a href='/topic/show?id=a4b96e542' target=_blank style='color:#2F92EE;'>#1型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=675, encryptionId=a4b96e542, topicName=1型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Fri Dec 09 22:06:00 CST 2016, time=2016-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637320, encodeId=df50163e3203e, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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=Sat Sep 17 23:06:00 CST 2016, time=2016-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759662, encodeId=01341e596625b, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Tue Mar 14 14:06:00 CST 2017, time=2017-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901370, encodeId=d60c19013e002, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Tue Jan 24 11:06:00 CST 2017, time=2017-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83454, encodeId=4d308345407, content=好研究,但是该研究97%是应用的他汀类药物,那么降低甘油三酯对1型糖尿病患者到底有没有益处呢?还是需要大规模研究进一步证实, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210704/cdd1076905df433c93873ae6d3d51aef/eae5c73864694494acb8435eb7d2e9bb.jpg, createdBy=ec7b92572, createdName=lshanp, createdTime=Sun May 01 16:15:00 CST 2016, time=2016-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255561, encodeId=d51b12555618a, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Thu Apr 28 14:06:00 CST 2016, time=2016-04-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473970, encodeId=80a714e397050, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Apr 28 14:06:00 CST 2016, time=2016-04-28, status=1, ipAttribution=)]

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郭艺芳:大多数心血管病患者适于中等强度他汀治疗

——解析美国VA血脂管理指南河北省人民医院 郭艺芳近日,美国退伍军人管理局等机构颁布了“降脂治疗降低心血管病风险临床实践指南”(以下简称“VA指南”)。全文发表于Ann Intern Med 。就学术地位而言,这一指南并无很大学术影响力。然而,因为VA指南发表于备受争议的2013年美国成人降胆固醇指南之后,其立场观点受到很多学者的关注。 全文下载:Management of Dyslip

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1. 降脂治疗依从性仍旧欠佳 降脂治疗是降低心血管疾病负担最为有效的治疗策略之一,预防心脑血管疾病的血脂新指南也已出台,但现实实践中对指南的依从程度堪忧。 一项研究显示,只有41.8%患者在卒中发生时服用降脂药物,达到低密度脂蛋白<70 mg/dl推荐值的患者仅占25%,另外,只有50%卒中合并糖尿病患者低密度脂蛋白水平在目标范围内。这项研究的研究对象是>900000名

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法国学者在无已知血管事件的老年人中研究了降脂药物(他汀或贝特类)与冠心病和卒中长期风险的关系,结果表明,他汀或贝特类药物可减少上述人群30%的卒中发生率。相关论文5月19日在线发表于《英国医学杂志》(简称BMJ)杂志。研究者们随机纳入了居住在法国3个城市社区人群7484例,年龄≥65岁(平均年龄73.9岁),女性占63%,入组时受试者均无无已知血管事

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