由于糖尿病而增加心血管疾病负担:弗雷明翰心脏研究
Caroline S Fox1, Sean Coady, Paul D Sorlie
1National Heart, Lung, and Blood Institute's Framingham Heart Study, 73 Mt Wayte Ave, Suite 2, Framingham, MA 01702-5827, USA. foxca@nhlbi.nih.gov
Circulation
|March 14, 2007
概括
与糖尿病相关的心血管疾病 (CVD) 的比例在Framingham超过50年增加了. 这凸显了糖尿病患者更好的DM预防和心血管疾病风险管理的需要.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 在过去的50年里,心血管疾病 (CVD) 的发病率和死亡率在美国显著下降.
- 糖尿病对心血管疾病总负担的相对贡献需要研究.
- 调查DM对心血管疾病的影响变化对于公共卫生战略至关重要.
研究的目的:
- 为了测试DM导致心血管疾病的负担在过去五十年中增加的假设.
- 量化随着时间的推移与DM相关的CVD风险的变化.
- 评估DM作为心血管疾病风险因素的人口可归因风险.
主要方法:
- 来自弗雷明汉心脏研究的45-64岁参与者的两个时期的比较:1952-1974年和1975-1998年.
- 利用考克斯的比例危险模型来评估与DM相关的心血管疾病事件的风险.
- 计算了每个时间段的DM作为心血管疾病风险因素的人口可归因风险.
主要成果:
- 作为心血管疾病风险因素的DM年龄和性别调整后的危险比率在早期为3.0,在后期为2.5.
- 在这两个时期之间,DM作为心血管疾病风险因素的可归因人口风险从5.4%增加到8.7% (P=0.04).
- 大多数与DM相关的心血管疾病风险增加在男性中被观察到,尽管多变量调整减轻了发现 (P=0.12).
结论:
- 在过去的50年里,因糖尿病而导致的心血管疾病的比例在弗雷明汉增加了.
- 这些发现强调了加强DM预防策略的必要性.
- 重点是积极治疗和控制DM患者心血管疾病风险因素.
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