Reduced Long-Term Risk of Aortic Aneurysm and Aortic Dissection Among Individuals With Type 2 Diabetes Mellitus: A Nationwide Observational Study.
Reduced Long-Term Risk of Aortic Aneurysm and Aortic Dissection Among Individuals With Type 2 Diabetes Mellitus: A Nationwide Observational Study.
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DOI：
10.1161/jaha.117.007618
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发表时间：
2018-01-24
影响因子：
5.4
通讯作者：
Eliasson B
中科院分区：
文献类型：
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作者：
Avdic T;Franzén S;Zarrouk M;Acosta S;Nilsson P;Gottsäter A;Svensson AM;Gudbjörnsdottir S;Eliasson B
尚未有研究研究2型糖尿病(T2 DM)患者主动脉瘤(AA)和主动脉夹层(AD)的长期风险，或AA或AD住院后的死亡率。在这项观察性队列研究中，我们将瑞典国家糖尿病登记处中T2 DM患者的数据和5名单独匹配的非糖尿病人群对照受试者(基于性别、年龄和县)与其他国家数据库联系起来，以记录住院和死亡情况。我们使用Kaplan-Meier曲线和Cox回归风险模型检验了AA和AD的住院风险以及AA和AD后的死亡风险。1998年至2015年期间，获得了448,319名T2 DM患者和2,251,015名CS患者的数据。T2 DM组平均随访时间为7.0年，CS组为7.2年。与对照组相比，T2 DM患者再障的相对风险降低28%(危险比0.72；95%可信区间0.68-0.76；P<；0.0001)，AD的相对风险降低47%(危险比0.53；95%可信区间0.42-0.65；P<；0.0001)。与对照组相比，T2 DM患者AA住院后死亡率的相对风险降低12%(危险比0.88；95%可信区间0.82-0.94；P<；0.0001)，AD后死亡的相对风险降低12%(危险比1.07；95%可信区间0.85-1.34；P=0.5859)。与CS相比，T2 DM患者AA和AD的风险以及因AA住院后死亡的风险显著降低。数据表明，在T2 DM患者中，主动脉组织中糖化的交联物可能在主动脉疾病的进展中起到保护作用。
No studies have examined long‐term risks for aortic aneurysm (AA) and aortic dissection (AD) or mortality after AA or AD hospitalization among patients with type 2 diabetes mellitus (T2DM). In this observational cohort study, we linked data for patients with T2DM in the Swedish National Diabetes Register, and 5 individually matched population‐based control subjects (CSs) without diabetes mellitus (on the basis of sex, age, and county), to other national databases to capture hospitalizations and death. We examined the risk of hospitalization for AA and AD, as well as mortality risk after AA and AD using Kaplan‐Meier curves and Cox regression hazards models. Data on 448 319 patients with T2DM and 2 251 015 CSs were obtained between 1998 and 2015. Mean follow‐up time was 7.0 years for the T2DM group and 7.2 years for the CS group. Patients with T2DM had a relative risk reduction of 28% (hazard ratio, 0.72; 95% confidence interval, 0.68–0.76; P<0.0001) for AA and a 47% relative risk reduction (hazard ratio, 0.53; 95% confidence interval, 0.42–0.65; P<0.0001) for AD compared with CSs. Patients with T2DM had a relative risk reduction of 12% (hazard ratio, 0.88; 95% confidence interval, 0.82–0.94; P<0.0001) for mortality after hospitalization for AA, and unaltered risk (hazard ratio, 1.07; 95% confidence interval, 0.85–1.34; P=0.5859) for mortality after AD, up to 2 years compared with CSs. Patients with T2DM had significantly reduced risks of AA and AD as well as reduced risk of mortality after hospitalization for AA, compared to CS. Data suggest that glycated cross‐links in aortic tissue may play a protective role in the progression of aortic diseases among patients with T2DM.