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Diabetes Care:1型糖尿病可促进更年期冠状动脉钙的进展

2019-09-27 xing.T MedSci原创

由此可见,1型糖尿病与CAC体积增加和CAC随着时间推移加速发展有关。与年龄和其他已知因绝经而恶化的CVD危险因素无关,与无糖尿病的女性相比,糖尿病女性的绝经所致的CAC进展更明显。

女性1型糖尿病与罹患心血管疾病(CVD)的风险较高相关。尽管更年期增加了CVD的风险,但尚不确定更年期如何影响1型糖尿病女性的CVD风险。近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,研究人员探究了更年期期患有和未患有1型糖尿病的妇女CVD的风险是否存在差异。

研究人员将1型糖尿病的绝经前妇女(n=311)和无糖尿病的绝经前妇女(n=325)纳入了1型糖尿病患者的冠状动脉钙化(CACTI)研究,并在18年期间进行了多达4次研究随访。冠状动脉钙(CAC)的体积是通过每次访问所获得的计算机断层扫描结果来测量的。纵向重复测量模型评估了糖尿病随时间推移对CAC体积的影响以及更年期对糖尿病与CAC之间关系的影响。

与1型糖尿病女性相比,1型糖尿病女性的CAC体积在基线时更高,并随时间增加更多。发现糖尿病与绝经之间存在显著的相互作用(P<0.0001):1型糖尿病绝经后妇女的CAC体积明显高于绝经前妇女(5.14±0.30 vs. 2.91±0.18 mm3),而没有糖尿病的妇女则无差异(1.78±0.26 vs. 1.78±0.17 mm3)。校正CVD危险因素后,这种相互作用仍然很明显。

由此可见,1型糖尿病与CAC体积增加和CAC随着时间推移加速发展有关。与年龄和其他已知因绝经而恶化的CVD危险因素无关,与无糖尿病的女性相比,糖尿病女性的绝经所致的CAC进展更明显。 

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    2019-09-29 1ddf0692m34(暂无匿称)

    学习了,谢谢分享

    0

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    2019-09-27 Lancet7820

    类似研究希望尽量在临床上应用,造福患者。

    0

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    2019-09-27 misszhang

    谢谢MedSci提供最新的资讯

    0

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心血管疾病是导致1型糖尿病(T1DM)患者死亡的主要原因,约35%青少年T1DM进入成年期至少会伴有2个心血管危险因素。因此,非常有必要采取措施预防或逆转T1DM患者的心血管病变。近期科罗拉多大学医学院儿童内分泌科研究人员发表了一项随机对照研究显示,青少年T1DM患者的胰岛素抵抗及心血管健康受损明显,而二甲双胍可有效改善上述异常。

Diabetes Care:1型糖尿病患者严重低血糖和酮症酸中毒发病率和微血管并发症患病率

由此可见,对于1型糖尿病成年人,血糖控制似乎比先前估计的要差。随着HbA1c的增加,所有并发症的发生率均增加。与HbA1c<7%相比,HbA1c≥9%分别与SH和DKA的发病率高出2倍和12倍有关。与较年长的成年人相比,较年轻的成年人血糖控制不佳相关的SH和DKA风险更高。

NEJM:替利珠单抗与1型糖尿病风险

由此可见,替利珠单抗可延迟高风险参与者进展为临床1型糖尿病。

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