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2型糖尿病缓解轨迹和糖尿病并发症风险的变化:基于人口的队列研究
Hajira Dambha-Miller1, Hilda O Hounkpatin1, Beth Stuart1
1Primary Care Research Centre, School of Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, England.
实现2型糖尿病缓解,即使是暂时的缓解,也会降低并发症风险. 持续缓解提供了对心血管疾病和死亡率的最大保护.
科学领域:
- 内分泌学和新陈代谢学
- 公共卫生和流行病学
- 心血管疾病研究研究
背景情况:
- 2型糖尿病的生化缓解可以通过饮食,运动和减肥等生活方式干预来实现.
- 了解长期糖尿病缓解模式及其对并发症的影响对于有效的患者管理至关重要.
研究的目的:
- 在一个大型基于人口的队列中,在七年内确定2型糖尿病缓解的不同轨迹.
- 调查这些缓解轨迹与患糖尿病相关并发症的风险之间的关联,包括心血管事件和死亡率.
主要方法:
- 基于组的轨迹建模被用于分析糖化血红蛋白 (HbA1c) 水平的纵向模式.
- 使用多变量Cox比例危险模型来评估已识别的缓解轨迹与各种健康结果之间的关系.
- 这项研究分析了来自大规模基于人口的队列的数据,随访期为7年.
主要成果:
- 确定了四种不同的糖尿病缓解轨迹:暂时缓解 (组1),降低HbA1c (组2),稳定高HbA1c (组3),稳定低HbA1c (组4).
- 与稳定高HbA1c (组3) 相比,暂时缓解 (组1) 和持续缓解 (组4) 与显著降低微血管并发症,宏血管并发症和心血管 (CVD) 事件的风险有关.
- 虽然持续缓解 (4组) 与3组相比,死亡风险较高,但暂时缓解 (1组) 的风险较低. 对于2组和3组,心血管疾病的结果是相似的.
结论:
- 糖尿病缓解轨迹显著影响患糖尿病并发症和死亡率的风险.
- 实现即使是暂时的缓解也有利于降低心血管结果的风险,因为减少了对高血糖的暴露.
- 持续缓解与最低的并发症风险有关,突出显示了2型糖尿病的长期生活方式管理的重要性.
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