HbA 1c as a risk factor for heart failure in persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
HbA 1c as a risk factor for heart failure in persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) study.
复制标题
DOI：
10.1007/s00125-008-1164-z
复制
发表时间：
2008-12
期刊：
影响因子：
8.2
通讯作者：
Coresh, J.
中科院分区：
文献类型：
--
作者：
Pazin-Filho, A.;Kottgen, A.;Bertoni, A. G.;Russell, S. D.;Selvin, E.;Rosamond, W. D.;Coresh, J.
糖尿病合并或不合并冠心病时心力衰竭（HF）的发病率均呈上升趋势。基于人群的前瞻性研究有助于描述HbA 1c（一种血糖控制指标）与HF风险之间的关系。我们研究了社区动脉粥样硬化风险（ARIC）研究中1，827名基线时无HF证据的糖尿病患者的HF住院或死亡发生率。考克斯比例风险模型包括年龄、性别、种族、教育、健康保险状况、饮酒量、BMI和WHR以及主要CHD风险因素（BP水平和药物、LDL和HDL胆固醇水平以及吸烟）。在糖尿病人群中，无CHD的患者每1,000人年的粗HF发病率较低（CHD阴性患者的发病率为15.5，CHD阳性患者的发病率为56.4，p<0.001）。HbA 1c每升高1%，非CHD组HF的校正HR为1.17（95% CI 1.11-1.25），CHD组为1.20（95% CI 1.04-1.40）。当分析仅限于在没有流行或偶发CHD（随访期间）的情况下发生的HF病例时，校正的HR仍为1.20（95% CI 1.11-1.29）。这些数据表明，HbA 1c是糖尿病合并或不合并CHD患者发生HF的独立危险因素。严格血液病控制的长期临床试验应量化不同治疗方案对HF风险降低的影响。
Heart failure (HF) incidence in diabetes in both the presence and absence of CHD is rising. Prospective population-based studies can help describe the relationship between HbA1c, a measure of glycaemia control, and HF risk. We studied the incidence of HF hospitalisation or death among 1,827 participants in the Atherosclerosis Risk in Communities (ARIC) study with diabetes and no evidence of HF at baseline. Cox proportional hazard models included age, sex, race, education, health insurance status, alcohol consumption, BMI and WHR, and major CHD risk factors (BP level and medications, LDL- and HDL-cholesterol levels, and smoking). In this population of persons with diabetes, crude HF incidence rates per 1,000 person-years were lower in the absence of CHD (incidence rate 15.5 for CHD-negative vs 56.4 for CHD-positive, p<0.001). The adjusted HR of HF for each 1% higher HbA1c was 1.17 (95% CI 1.11–1.25) for the non-CHD group and 1.20 (95% CI 1.04–1.40) for the CHD group. When the analysis was limited to HF cases which occurred in the absence of prevalent or incident CHD (during follow-up) the adjusted HR remained 1.20 (95% CI 1.11–1.29). These data suggest HbA1c is an independent risk factor for incident HF in persons with diabetes with and without CHD. Long-term clinical trials of tight glycaemic control should quantify the impact of different treatment regimens on HF risk reduction.
登录
查看更多内容
影响因子：
37.8
作者：
Held, C.;Gerstein, H. C.;Teo, K.
通讯作者：
Teo, K.
影响因子：
13.6
作者：
Kottgen, Anna;Russell, Stuart D.;Coresh, Josef
通讯作者：
Coresh, Josef
影响因子：
105.7
作者：
Stratton, IM;Adler, AI;Holman, RR
通讯作者：
Holman, RR
影响因子：
158.5
作者：
Gerstein, Hertzel C.;Miller, Michael E.;Friedewald, William T.
通讯作者：
Friedewald, William T.
影响因子：
7.7
作者：
Cleary, Patricia A.;Orchard, Trevor J.;Nathan, David M.
通讯作者：
Nathan, David M.