1型和2型糖尿病患者患有外周动脉疾病的四肢和心血管事件风险
Daniel Sykora1, Christine Firth2, Marlene Girardo3
1Mayo Clinic School of Graduate Medical Education, Rochester, MN, USA.
VASA. Zeitschrift fur Gefasskrankheiten
|July 31, 2023
概括
患有1型糖尿病 (T1DM) 的周围动脉疾病 (PAD) 患者比患有2型糖尿病 (T2DM) 患者面临更高的肢体事件 (LE) 风险. 心血管事件 (CVE) 风险和死亡率在各组之间相似.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 血管医学 血管医学
背景情况:
- 周围动脉疾病 (PAD) 是不良四肢事件 (LE) 和心血管事件 (CVE) 的重要危险因素.
- PAD经常与1型糖尿病 (T1DM) 和2型糖尿病 (T2DM) 一起存在.
- 在T1DM和T2DM患者中,LE和CVE的比较风险与PAD患者的比较风险尚不清楚.
研究的目的:
- 为了比较患有PAD和T1DM或T2DM患者的四肢事件 (LE) 和心血管事件 (CVE) 的风险.
- 为了确定T1DM和T2DM患者与PAD之间的结果差异.
主要方法:
- 通过脚-手腕指数 (ABI) 诊断出PAD和DM的10,156名患者的回顾性分析.
- 主要结局包括LE (关键四肢缺血/血管截肢) 和CVE (心肌梗塞/缺血中风).
- 多变量考克斯回归调整了风险因素,包括年龄,高血压,高脂血症,吸烟和HbA1c.
主要成果:
- 与T2DM患者相比,T1DM患者年轻,HbA1c较高,并有更多的并发症.
- 与T2DM患者相比,T1DM患者的肢体事件 (LE) 风险显著更高 (HR 1.58).
- 心血管事件 (CVE) 风险和全因死亡率在T1DM和T2DM患者之间是相似的.
结论:
- 与T2DM患者相比,患有PAD和T1DM患者的肢体事件 (LE) 风险明显更高.
- 心血管事件 (CVE) 风险和整体死亡率在T1DM和T2DM PAD患者之间没有显著差异.
- 在T1DM患者中考虑加强LE风险管理策略是合理的.
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