糖尿病,肥胖和心血管疾病表型之间的关系:英国生物银行队列研究
Oliver I Brown1, Michael Drozd1, Hugo McGowan1
1Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, U.K.
Diabetes care
|June 27, 2023
概括
肥胖和糖尿病一起增加心血管疾病的风险. 即使是正常体重的糖尿病患者也面临着与没有糖尿病的肥胖患者相比的死亡风险,这突出了复杂的相互作用.
科学领域:
- 心血管医学 心血管医学
- 代谢障碍 代谢障碍 代谢障碍
- 公共卫生 公共卫生
背景情况:
- 肥胖和糖尿病是普遍存在的疾病,经常同时发生.
- 它们对心血管疾病 (CVD) 风险的独立和联合影响尚未完全阐明.
- 了解这些关系对于有针对性的心血管疾病预防策略至关重要.
研究的目的:
- 研究身体质量指数 (BMI) 和糖尿病对心血管疾病生物标志物,事件和死亡率的个人和联合影响.
- 在一个大群体中,根据BMI类别和糖尿病状况对心血管风险进行分层.
主要方法:
- 利用了来自451,355名参与者的英国生物库数据,按特定种族的BMI (正常,超重,肥胖) 和糖尿病状况分层.
- 评估的心血管生物标志物:动脉内心介质厚度 (CIMT),动脉硬度,左心室喷射率 (LVEF) 和心脏收缩率指数 (CCI).
- 采用波桑回归来估计心肌梗塞,缺血性中风和心血管死亡的发病率比率 (IRR),使用正常体重的非糖尿病人作为参考组.
主要成果:
- 在非糖尿病患者中,超重和肥胖与不良生物标志物相关 (较高的CIMT,动脉硬度,CCI;较低的LVEF). 这些关联在糖尿病组中减弱.
- 糖尿病与所有BMI类别的不良心血管生物标志物概况有关,最显著的是正常体重的个体.
- 在非糖尿病患者中,心血管事件和死亡率与BMI增加. 值得注意的是,正常体重的糖尿病患者的心血管死亡率与没有糖尿病的肥胖患者相似.
结论:
- 肥胖和糖尿病与不良的心血管生物标志物和增加的死亡风险具有附加关联.
- 虽然脂肪度量比糖尿病度量更强烈地与生物标志物相关,但两者都显示出弱相关性,这表明其他因素有助于正常体重糖尿病患者心血管疾病风险增加.
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