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2型糖尿病患者的有意减肥的临床影响:一个真实世界的数据库研究
Akshay Jain1,2, Peter Nørgaard Kristensen3, Rie Strøbeck Wasehuus3
1TLC Diabetes and Endocrinology, Surrey, British Columbia, Canada.
蓄意减肥显著降低了患有肥胖和2型糖尿病 (T2D) 的人群中微血管和宏血管并发症的风险. 降低BMI和改善血糖控制 (HbA1c) 都有助于这些积极的健康结果.
科学领域:
- 内分泌学和新陈代谢学
- 心血管研究研究心血管研究
- 糖尿病管理 糖尿病管理
背景情况:
- 肥胖和2型糖尿病 (T2D) 是微血管和宏血管并发症的重要危险因素.
- 有效的管理策略对于减轻这种患者群体的长期健康风险至关重要.
研究的目的:
- 评估故意减肥对成年肥胖和T2D患者微血管和宏血管并发症发生率的影响.
- 确定降低体重指数 (BMI) 和改善血糖控制对并发症风险的独立和联合影响.
主要方法:
- 使用来自临床实践研究数据链接 (CPRD) Aurum数据库 (2006-2022) 的数据的回顾性队列研究.
- 纳入标准:肥胖的成年人 (BMI ≥30 kg/m2) 和T2D.
- 分析涉及量化微血管 (视网膜病变,神经病变,CKD) 和宏血管 (MI,PAD,中风) 并发症的发生率,并使用Cox比例危险回归估计风险.
主要成果:
- 分析了100507个人的队列,平均相对BMI降低了-2.2%,HbA1c没有显著绝对变化.
- 每一次BMI降低1%都与复合微血管 (HR 0.990) 和宏血管 (HR 0.996) 并发症风险显著降低有关.
- 每降低1%的HbA1c都与微血管 (HR 0.875) 和宏血管 (HR 0.872) 复合并发症的风险显著降低有关.
结论:
- 蓄意减肥,导致BMI降低,独立地降低了肥胖和T2D患者微血管和宏血管并发症的风险.
- 血糖控制 (HbA1c) 的改善也独立降低了这些并发症的风险.
- 同时降低BMI和HbA1c显示出协同效益,显著降低了高风险人群中的并发症风险.
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