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Diabetes Care:1型糖尿病患者体重增长过快对心血管结局的影响!

2017-11-15 xing.T MedSci原创

DCCT后第一个13年中,1型糖尿病患者采用INT治疗相比于CONV可以降低大血管事件,即使发生体重过度增加。在这之后,总心血管事件在Q4INT组显著增加,CONV组也有类似结果。需要更长的时间进行随访,以确定这种趋势是否持续,并导致更多的主要心血管事件。

与传统治疗(CONV)相比,1型糖尿病患者接受强化治疗(INT)可以减少心血管疾病(CVD)事件的发生,但它也会导致更多的体重增加。近日,糖尿病领域权威杂志Diabetes Care上发表了研究文章,研究人员旨在评估1型糖尿病患者接受INT治疗所致体重增加是否与随后的CVD事件独立相关。

研究人员采用从基线到糖尿病控制和并发症试验(DCCT)最后一次随访的BMI变化来衡量体重增长情况,将1213名18岁以上参与DCCT试验随机治疗组的受试者的体重增长进行四分位数(Q)分组(INT和CONV)。然后,确定了体重增加对CVD危险因素和20年随访观察结局的影响。

研究人员发现Q4INT组受试者经历了更大比例的体重增加(BMI中位数变化为6.08kg/m2)、CVD危险因素增加和更大比例的受试者需要抗高血压和血脂药物治疗,与Q1-3INT组受试者和相应的CONV组相比。在平均26年的随访期间,INT或CONV组Q4受试者主要和总的心血管事件发生率与Q1-Q3受试者没有统计学差异。到了第14年,然而,发生CVD事件的曲线Q4INT组明显高于Q1-Q3INT组(P=0.024),在CONV上也观察到了类似的结果。

DCCT后第一个13年中,1型糖尿病患者采用INT治疗相比于CONV可以降低大血管事件,即使发生体重过度增加。在这之后,总心血管事件在Q4INT组显著增加,CONV组也有类似结果。需要更长的时间进行随访,以确定这种趋势是否持续,并导致更多的主要心血管事件。

原始出处:

Jonathan Q. Purnell,et al.Impact of Excessive Weight Gain on Cardiovascular Outcomes in Type 1 Diabetes: Results From the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study.Diabetes Care 2017. https://doi.org/10.2337/dc16-2523

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