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未见的威胁:亚临床动脉样硬化如何增加1型糖尿病患者的死亡风险
Lidia Sojo-Vega1,2, Mònica Recasens1, Joan Martínez2
1Department of Endocrinology, Diabetes Unit, University Hospital Dr, Josep Trueta of Girona, Av. França s/n, 17007, Girona, Spain.
亚临床动脉样硬化在1型糖尿病患者中很常见,并显著增加了主要心血管事件和死亡的风险. 识别男性性别和糖尿病病等预测因素有助于个性化风险管理.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
背景情况:
- 心血管疾病 (CVD) 是1型糖尿病 (T1D) 中的主要死亡原因.
- 亚临床动脉样硬化检测可以改善心血管疾病风险分层,并在T1D中个性化治疗.
- 这项研究调查了未临床动脉样硬化患病率,预测因素和T1D患者的生存影响,而没有明显的CVD.
研究的目的:
- 确定T1D患者中亚临床动脉样硬化的流行率和预测因素.
- 评估亚临床动脉样硬化对患者在至少5年随访期间的生存时间的影响.
主要方法:
- 对507名符合特定年龄/持续时间标准的T1D患者 (2015-2023) 的观察性研究.
- 亚临床动脉样硬化评估使用动脉和大腿动脉超声波.
- 生存分析 (Kaplan-Meier) 监测了主要心血管不良事件 (MACE) 和全因死亡率.
主要成果:
- 在43%的患者中发现了亚临床动脉样硬化.
- 预测因素包括男性性别,糖尿病脏病,烟草使用,较高的HbA1c,年龄较大和糖尿病持续时间较长.
- 亚临床动脉样硬化与MACE (HR 25.1) 和死亡 (OR 7.57) 的风险显著增加有关.
结论:
- 亚临床动脉样硬化是T1D中死亡率和MACE的独立预测因子.
- 确定临床预测因素对于风险分层和个性化预防策略至关重要.
- 早期检测和治疗亚临床动脉样硬化可以改善高风险T1D患者的结果.
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