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2型糖尿病中不明原因的残留风险:问题有多大?
Sivaram Neppala1,2, Jemema Rajan1,2, Eric Yang3
1Divisions of Diabetes, UT Health San Antonio, Texas, TX, 75229, USA.
心血管疾病仍然是2型糖尿病患者的主要威胁. 即使有干预措施,在2型糖尿病中,心血管风险的很大一部分仍然无法解释.
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:
- 心血管疾病 (CVD) 是2型糖尿病 (T2D) 患者的主要死亡原因.
- 不到10%的T2D患者达到主要心血管疾病风险因素的推治疗目标.
- 了解T2D中无法解释的心血管风险对于改善患者的治疗结果至关重要.
研究的目的:
- 为了评估T2D患者绝对心血管 (CV) 风险的比例,通过主要的CV干预试验来解释.
- 确定目前对T2D中心血管风险降低的理解的差距.
- 探索未知的心血管风险的潜在原因.
主要方法:
- 对多项长期心血管干预试验的审查,重点是针对性治疗.
- 对STENO-2试验的分析,这是一个前性的多因素干预研究.
- 从审查的试验中计算累积的绝对心血管风险降低.
主要成果:
- 主要心血管干预试验显示,对主要心血管不良事件 (MACE) 有不同的影响.
- 通过加强多因素干预,STENO-2试验证明了20%的绝对心血管风险降低.
- 在汇总试验数据后,T2D绝对心血管风险的显著44.1%仍然无法解释.
结论:
- 主要心血管风险因素之间的协同相互作用可能导致T2D中无法解释的风险.
- 为了最大限度地降低心血管风险,必须同时对所有主要心血管风险因素进行管理,以达到指导方针目标.
- 需要进一步的研究来阐明和解决T2D患者中剩余的无法解释的CV风险.
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