在糖尿病患者中沉默心肌缺血的患病率和预测因素
Hafiz Abdul Manan1,2, Hammad Rauf Chishti3, Franklin Dzigbodi Hewlett4
1Cardiology, London Northwest University Healthcare NHS, London, GBR.
Cureus
|May 19, 2025
概括
无声心肌缺血 (Silent myocardial ischemia,SMI) 影响了超过三分之一的糖尿病患者,由于缺乏症状,往往未被发现. 吸烟,血糖控制不良和糖尿病持续时间较长等关键风险因素需要针对性查,以便早期检测并减少心血管事件.
科学领域:
- 心脏病学 心脏病学
- 糖尿病学 糖尿病学
- 预防医学 预防医学
背景情况:
- 无声心肌缺血症 (SMI) 是糖尿病患者心血管疾病发病率和死亡率的重要,未被确诊的因素.
- 糖尿病自主神经病变可以掩盖典型的胸痛症状,导致未被检测到的缺血发作.
- 慢性高血糖,内皮功能障碍和炎症使糖尿病患者易患SMI,需要积极的检测策略.
研究的目的:
- 确定糖尿病成年人中SMI的患病率和确定关键风险因素.
- 通过针对性风险分层在高风险糖尿病人群中加强SMI的早期检测.
- 为量身定制的查策略提供信息,旨在减少糖尿病患者心血管事件.
主要方法:
- 一项涉及162名糖尿病患者 (年龄≥40岁,糖尿病持续时间≥5年) 没有先前冠状动脉疾病的横截面研究.
- 综合性评估包括病史,体检,HbA1c,脂质概况,心肌输液成像,运动压力测试和休息心电图.
- 多变量逻辑回归分析确定了SMI的独立预测因素,统计学意义设置为p < 0.05.
主要成果:
- 在研究的糖尿病患者中,SMI在37.65%中被检测出来.
- SMI的独立预测因素包括吸烟 (OR:2.67),高血压 (OR:1.89),失脂症 (OR:2.15),糖尿病持续时间>10年 (OR:2.34),以及血糖控制不良 (HbA1c>7%) (OR:3.21).
- 晚年 (每年或1.05) 和55岁以上的年龄显著与SMI风险增加有关.
结论:
- 超过三分之一的糖尿病患者患有SMI,通常无症状,并未通过常规查检测到.
- 确定的主要危险因素是吸烟,血糖控制不良,长期糖尿病,脂质不良,高血压和55岁以上.
- 将非侵入性心脏评估纳入高风险糖尿病患者的查方案,可以促进早期诊断和干预,减少未来的心血管事件.
相关概念视频
01:17Ischemic Heart Disease: Overview
1.1K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.1K
01:22Diabetes Mellitus: Type 2 and Gestational
2.1K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.1K
01:15Diabetes: Symptoms, Diagnosis, and Complications
494
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
494
01:20Pathophysiology of Diabetes
833
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
833
01:22Diabetes Mellitus: Overview and Type I Subtype
2.3K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.3K