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糖尿病并发症和并发症作为2型糖尿病患者MACE的危险因素及其随时间的发展:一项基于丹麦注册的病例对照研究
Asger Ahlmann Bech1, Mia Daugaard Madsen1, Annika Vestergaard Kvist1
1Steno Diabetes Center North Denmark, Aalborg University Hospital, Gistrup, Denmark.
Journal of diabetes
|March 26, 2025
概括
随着时间的推移,二型糖尿病患者的重大不良心血管事件 (MACE) 减少. 虽然神经病变和高胆固醇血症等并发症仍然存在风险,但它们与MACE的关联已经减少,这表明管理策略得到了改进.
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:
- 2型糖尿病是一个日益严重的全球健康问题,与心血管风险增加有关.
- 主要不良心血管事件 (MACE) 是糖尿病人群中发病率和死亡率的重要原因.
- 了解MACE和相关风险因素的时间趋势对于有效的糖尿病管理至关重要.
研究的目的:
- 检查2型糖尿病患者心血管风险因素和MACE之间的关联.
- 评估这些协会在两个不同的10年期间 (2002-2011和2012-2021) 发生了怎样的变化.
- 为了确定特定的糖尿病并发症和影响MACE风险随着时间的推移的并发症.
主要方法:
- 从丹麦的登记册 (2002-2021) 中确定了一大群372,328名2型糖尿病患者.
- 参与者被分为两个10年期 (TP1: 2002-2011,TP2: 2012-2021) 并对MACE病例和对照进行匹配.
- 预先选择的糖尿病并发症 (脏病,神经病,视网膜病) 和并发症 (高血压,心房动,心力衰竭,高胆固醇血症) 被分析为暴露.
主要成果:
- 第一次MACE的发病率在后期 (TP2) 与早期 (TP1) 相比显著降低.
- 病,神经病和视网膜病一直与两个时期的MACE风险增加有关.
- 高血压,心房动和心力衰竭仍然是显著的MACE风险因素,而高胆固醇血症的相关性降低了,神经病变也降低了TP1和TP2之间的关系.
结论:
- 第一次MACE在2型糖尿病患者的总体患病率有所下降,这表明心血管风险管理取得了进展.
- 尽管下降,但特定的糖尿病并发症和并发症仍然是MACE的重要预测因素.
- 随着时间的推移,神经病变和高胆固醇血症与MACE的相关性减少可能反映了改善的治疗策略和风险因素控制.
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