脆弱性在预测1型糖尿病并发症和死亡的常规风险因素方面表现优于脆弱性
Markus J Haapanen1, Fanny Jansson Sigfrids2, Anni Ylinen3
1Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Australian Frailty Network, The University of Queensland, Woolloongabba, Queensland, Australia; Folkhälsan Research Center, Helsinki, Finland; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
虚弱显著增加了心血管和糖尿病并发症的风险和1型糖尿病患者的死亡率. 常规的脆弱性评估可以改善风险预测和对这一群体的个性化护理.
科学领域:
- 老年学是一门学科.
- 内分泌学 在内分泌学.
- 心脏病学 心脏病学
背景情况:
- 1型糖尿病 (T1D) 管理传统上侧重于血糖控制和常规风险因素.
- 虚弱的影响,一个增加的脆弱性状态,T1D并发症和生存还不清楚.
研究的目的:
- 调查是否虚弱预测T1D成人心血管和糖尿病相关并发症和死亡率.
- 量化脆弱对不良事件发生时间的影响.
- 将脆弱的预测能力与已确定的风险因素进行比较.
主要方法:
- 分析了全国4,819名患有T1D (FinnDiane) 的成年人的队列.
- 脆弱性在基线时使用脆弱性指数进行评估,并被分类为非脆弱,前脆弱或脆弱.
- 参与者被跟踪了19年的中位数,主要的心血管事件,替代疗法,严重的视网膜病变,和死亡率,使用国家注册和生存模型.
主要成果:
- 在基线时,13%的参与者是脆弱的,54%是脆弱前的,53%是非脆弱的.
- 脆弱的个体面临着3至118倍的并发症风险,并发症的发生时间加速了2至6年.
- 脆弱性预测了全因死亡风险的十倍,使生存时间减少4.5年,并显示出比单个常规风险因素更好的预测性能.
结论:
- 在T1D的成年人中,脆弱性很普遍,并且独立地预测了早期和高风险的并发症和死亡率.
- 将常规的脆弱性评估整合到T1D护理中可以提高风险分层,并促进个性化治疗策略.
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