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2015年第75届美国糖尿病协会（ADA）科学年会正在美国波士顿召开。北京大学人民医院内分泌代谢科纪立农教授团队的的一项研究在ADA2015年会普通壁报专场（General Poster Session）上发布。该研究调查中国2型糖尿病（T2D）患者队列心血管疾病（CVD）事件的独立预测因素。以下是研究摘要译文。
目的：在具有心血管疾病高危风险的大型中国T2D队列中确定CVD并发症的发生率。
方法：本研究是一项多中心、前瞻性、纵向队列研究。纳入心血管疾病高危人群，随访3年，每间隔6个月随访1次。纳入标准：1）≥40岁；2）T2D诊断≥6个月；3）经证实的高血压和血脂异常，一个或多个其它CVD风险（超重、微量白
结果：从2011年至2014年，在68家医院招募并随访了4722例患者。45.2％为男性，平均年龄65.9岁。糖尿病病程平均7.2年。1年、2年、3年CVD复合终点事件累积发生率分别为2.0％、3.9％和6.2％。多变量Cox模型显示，年龄≥65岁（危险比[HR] = 2.19；95％可信区间[CI]：1.54-3.12; P <0.001），和既往CVD史（HR = 1.65；95％CI：1.25-2.19 ; P <0.001）与复合CVD事件风险较高相关；而控制HbA1c <7.0％（HR = 0.68（95％CI：0.52-0.90；P <0.01）、血压<140/80 mmHg（HR = 0.57；95％CI：0.43-0.75；P <0.0001）均与复合心血管事件风险较低相关。控制LDL-C < 2.6％与患者预后并无显著相关。
结论：这是首个探讨中国T2D患者心血管疾病终点的前瞻性队列研究。年龄和心血管疾病史是心血管疾病并发症的独立预测因素；而适当的血糖控制和血压控制可降低心血管疾病并发症的风险。
【研究摘要】
Abstract Number: | 1491-P |
| Title: | Independent Predictors of Cardiovascular Disease (CVD) Events Identified in a Cohort of Type 2 Diabetes (T2D) Patients in China |
| Authors: | XIAOLING CAI, DAYI HU, CHANGYU PAN, JIANPING WENG, QIUHE JI, BENLI SU, JUMING LU, HAOMING TIAN, GUANGWEI LI, DAJIN ZOU, DANYI ZHANG, HANJING ZHUO, LINONG JI, Beijing, China, Guangzhou, China, Xi'an, China, Dalian, China, Chengdu, China, Shanghai, China, Berwyn, PA |
| Abstract: | The aim of this study is to determine the incidence of CVD complications in a large Chinese T2D cohort with high risk of CVD. This was a multi-center, prospective and longitudinal cohort study. Patients with high risk of CVD were enrolled and followed up for 3 years at every 6-month interval. The inclusion criteria were: 1) ≥40 years old; 2) T2D diagnosis ≥6 months; 3) with confirmed hypertension and dyslipidemia, and one or more other CVD risks (overweight, microalbuminauria /proteinuria, previous CAD or stroke history, and ≥65 years old). The primary endpoint was the composite of CVD events (defined as the first occurrence of acute myocardial infarction, stroke or death from cardiovascular causes). All statistical analyses were done using SAS 9.4. In year 2011 to 2014,4722 patients from 68 hospitals were recruited and followed up. 45.2% were male and the mean age was 65.9 years old. The median duration of diabetes was 7.2 years. The 1-year, 2-year, and 3-year cumulative incidence rates of the composite of CVD events were 2.0%, 3.9%, and 6.2%, respectively. Multivariate Cox models showed that age ≥65 yrs (Hazard Ratio [HR]=2.19; 95% confidence interval [CI]: 1.54-3.12; p<0.001) and prior CVD history (HR=1.65; 95% CI: 1.25-2.19; p<0.001) were associated with the higher risk of the composite CVD events; while the adequate control of HbA1c<7.0% (HR=0.68 (95% CI: 0.52-0.90; p<0.01) and blood pressure < 140/80 mmHg (HR=0.57; 95% CI: 0.43-0.75; p<0.0001) were associated with lower risk of the composite CVD events. Adequate control of LDL-c<2.6% was not significantly associated with the outcome. This was the first report on CVD outcome of T2D patients from prospective cohort study in Chinese individuals with T2D in China. Age and presence of CVD history were independent predictors of CVD complications; while adequate glycemic control and blood pressure control were associated with lower risks of CVD complications. |
会议专题>>>2015年美国糖尿病协会（ADA）年会
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